To paraphrase a remark Mark Twain may have made: Rumors of the death of cardiac surgery are premature. Hopefully, this is true, but the vibe is that surgery is on the way out and the only future for cardiac surgeons is to adopt minimally invasive procedures. This movement to percutaneous approaches has been building for 46 years, ever since Andreas Gruentzig demonstrated that coronary revascularization could be done that way in “an awake and comfortable patient.” More recently percutaneous aortic valve implantation has virtually replaced surgical approaches for aortic stenosis. Surgery volumes for coronary and structural heart procedures continue to decrease. Practicing surgeons are participating in structural heart percutaneous interventions partly because of regulatory requirements, but their open surgery volumes are declining, and one wonders if all of them are maintaining their open surgical skills. Despite these changes, the recommendations for coronary surgery remain strong for numerous subsets in the guidelines based on the available evidence.