The aging of society and the higher incidence of cardiovascular diseases with advancing age are leading to greater numbers of elderly patients，aged over 70 years old, undergoing cardiac surgery. Although there are more risk factors in elderly patients，currently, coronary artery surgery, valvular surgery and aortic surgery can be performed with a short- and long-term outcome comparable to those of younger patients. The main difference between elderly and younger patients with regard to the outcome after cardiac surgery is the incidence of stroke. Minimally invasive and hybrid procedures are trends in cardiovascular surgery in elderly patients.