Aim. To analyze and compare surgical results in patients with aortic root and ascending aortic pathology through mini-access and standard midline sternotomy. Material and methods. For the period January 2015 — September 2016 in the Aortic Surgery Department 21 patients underwent surgical treatment of aortic root and ascending aortic pathology via minimal access. In all cases J-mini-sternotomy was performed in the 4th right intercostal space. Intraoperative and early postoperative period (6—8 days) data were analyzed. Results. There were no cases of conversion to total midline sternotomy. J-mini-sternotomy significantly decreases intraoperative blood loss (750±143 ml and 758.3±156 ml in mini-sternotomy group vs. 907±130 ml and 908.33±132.01 ml total midline sternotomy; p<0.05) and pain syndrome (1—2 scores in mini-sternotomy vs. 3—4 scores in total midline sternotomy), and is also associated with earlier extubation (4.3±1.9 hours vs. 9.9±10.6 hours, respectively; p<0.05). Conclusion. Minimally invasive access significantly facilitates patients’ recovery. So this method is advisable if it is technically possible.