During the last 8 years, many different approaches for minimally invasive aortic valve surgery have emerged. We have developed a technique that enables total endoscopic aortic valve replacement with port access, via a small right lateral thoracotomy with only soft tissue retraction and minimally invasive aortic crossclamping. The operation is performed under video guidance, since no direct eye vision is possible. We believe this is the first such operation performed in cardiac surgery and that it mak es possible broadening of indications for nonsternotomy-video-directed surgery in the future.