Advances in video-assisted techniques in the fields of general and thoracic surgery have led to the application of this technology in experimental and clinical cardiac surgery. Visualization of intracardiac anatomy and pathology allows procedures to be performed without violation of ventricular muscle, thus preserving myocardial function. We present the case of a patient with a recent myocardial infarction, found to have a large left ventricular thrombus on echocardiogram. By applying thoracoscopic surgical technology we successfully removed the thrombus during emergency coronary artery revascularization and avoided myotomy.