Cardiac surgery has offered to millions of patients over the last three decades several surgical procedures which have been associated to an improved survival and symptoms-free quality of life compared to any other type of available clinical treatment. In the last decade we have witnessed the clinical introduction of technically simpler percutaneous interventions which have been rising exponentially due to their less invasive nature and despite the lack of long lasting and proven results. A small community of cardiac surgeons worldwide has used new technologies in order to create technically demanding but less invasive cardiac operations which retain the long lasting proven patients' benefits of traditional cardiac operations. The present talk is a review of minimal access (key-hole') cardiac operations including aortic, mitral valve surgery and coronary bypass surgery, which have been possible thanks to the dedicated interaction between surgical innovators and new technologies including robotic systems such as surgical telemanipulators.