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Department of Cardiothoracic Surgery, DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA; Weill Cornell Medicine, New York, NY, USA Correspondence to: Moritz C. Wyler von Ballmoos, MD, PhD, MPH. Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX 77030, USA. Email: mcwylervonballmoos@houstonmethodist.org. Provenance: This is an invited article commissioned by the Editorial Office, Annals of Translational Medicine. Comment on: Liu J, Chen B, Zhang YY, et al. Mitral valve replacement via minimally invasive totally thoracoscopic surgery versus traditional median sternotomy: a propensity score matched comparative study. Ann Transl Med 2019;7:341.

Minimally invasive mitral valve surgery to maximally benefit patients—what is the key to success today and tomorrow?