IJCS | Volume 33, Nº1, January / February 2019

23 1. Silva JF, Cavalcante MP, Montenegro RB, Lira R, Melo EC, Castro JV. Minimally invasive cardiac surgery versus sternotomy - Pain investigation. Int J Cardiovasc Sci. 2020;33(1):24-33. 2. GammieJS,ChikweJ,BadhwarV,ThibaultDP,VemulapalliS,ThouraniVH, et al. IsolatedMitral Valve Surgery: The Society of Thoracic SurgeonsAdult Cardiac Surgery Database Analysis. Ann Thorac Surg. 2018;106 (3):716-27. References Tirone E. David Pain after cardiac surgery Int J Cardiovasc Sci. 2020;33(1):22-23 Editorial This is an open-access article distributed under the terms of the Creative Commons Attribution License factor for the decision to perform a minimally invasive approach. But more importantly, I believe, is the fear of failure. Today, elective cardiac surgery is expected to be performed with very low operative mortality and morbidity, and experienced cardiac surgeons are reluctant to change. The ingrained “do no harm” prevents us from adopting newer surgical approaches than the ones we have mastered. Innovation and progress require that we step out of our comfort zone while keeping patients safe.