Background: Video - assisted thoracoscopic minimally invasive mitral valve replacement, associated with fast tract anesthesia and early extubation, was accepted in clinical practice. At Viet Duc University Hospital, we began to use this technique in January 2021. The purpose of this study is to evaluate the initial results. Methods: This is a retrospective, descriptive study with a convenient sample size, including all acceptable patients from January to August 2021. Results: There were 12 patients with 41.7% male and average age 53.8 ± 6.3 (range 42 - 63). There was no hospital mortality. Cardio pulmonary bypass time and aortic cross clamp time were 108.0 ± 23.8 minutes (range 80 - 157), 86.3 ± 16.7 minutes (range 63 - 115) and 3.4 ± 0.5 hours (range 3 - 4.8) relatively. Ventilation time, ICU length of stay and hospital stay were 23.3 ± 8.3 minutes (range 11 - 42), 21.9 ± 8.6 hours (range 15 - 48) and 14.7 ± 6.3 days (range 10 - 16) relatively. Three patients had temporary agitation after surgery and there are no other complications. Conclusion: A combination between video-assisted thoracoscopic minimally invasive mitral valve replacement and fast tract cardiac anesthesia was feasible and our initial results showed significantly reduce ventilation time and length of ICU stay in study group without serious complications