The minimization of surgical trauma in cardiac surgery for the treatment of heart diseases follows the trends in the other surgical specialties, which are dictated by the development of technology, surgical instruments, and last but not least by the patient’s requirements to limit the cosmetic defect resulting from the surgical intervention. Some cardiac surgery patients refuse conventional surgical access—median sternotomy, although they are aware that the long-term results of surgical treatment far outweigh the inconvenience of the immediate cosmetic result. The minimally invasive surgical technique is rapidly entering the treatment of isolated valvular pathologies, and in recent years in the treatment of coronary artery disease, starting with limited surgical approaches under direct vision, progressing to endoscopic assisted interventions and reaching totally endoscopic or robot-assisted interventions, thus limiting surgical trauma and possible wound complications, and taking into account the patient’s requirements for a good cosmetic result. This is not the case with combined cardiac pathology, where it is not possible to correct all pathological changes with minimally invasive access, and in some conditions the risk of standard open surgery is too high, for example, in aortic pathology. In these cases, hybrid surgical techniques are increasingly entering—limited surgical access in combination with interventional procedures, with the goal of the hybrid procedure being a good clinical outcome, low risk of post-procedural complications, and a cosmetic outcome desired by the patient.