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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.