Extracorporeal circulation used in aortocoronary bypass graft operations for the past 30 years has several adverse effects, including ARDS, coagulation disturbances, embolism and neurologic deficits. These operations have become very expensive even for the developed countries. Invasive procedures, e.g. balloon dilatation, coronary stents, coronary rotational and laser angioplasty, have failed to reduce the cost of treatment in these patients. Minimally invasive coronary surgery is a new technique allowing myocardial revascularisation on the beating heart without the use of extracorporeal circulation. Its main advantages over the standard method include reduced morbidity, shorter hospital stay and lower treatment costs.