Minimally invasive techniques are increasingly being adopted in cardiac surgery. Although thoracotomy-based approaches are well established for selected coronary and mitral operations, median sternotomy remains the standard access for most combined pathologies because of technical complexity and limited evidence. In this case series, we describe two highly selected patients who underwent combined coronary artery bypass grafting and mitral valve repair via bilateral mini-thoracotomy without sternotomy. We report the operative strategy, perioperative course, and early outcomes as a feasibility-focused technical experience. In both patients, the procedures were completed without conversion to sternotomy, mitral repair was confirmed intraoperatively by transesophageal echocardiography, and no major perioperative adverse events listed in Table~1 were observed. In conclusion, bilateral mini-thoracotomy appears technically feasible in carefully selected patients treated by an experienced minimally invasive team; however, this two-patient case series does not permit comparative claims regarding superiority, complication reduction, or long-term effectiveness.
