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Introduction: Based on a longtime voluntary registry founded by the Ministry of Health of the Slovak Republic in 2012, well-defined data of all adult cardiac surgery procedures performed in Slovakia at the National Institute of Cardiovascular Diseases during the year 2020 are analyzed. Material and method: For this period, a total of 1021 procedures were submitted to the registry from the National Institute of Cardiovascular Diseases. Results: The unadjusted in-hospital survival rate for the 401 isolated coronary artery bypass grafting procedures including urgent and emergency procedures (relatioship on-/off pump 4.5:1) was 97%. For isolated 306 isolated heart valve procedures (30 transcatheter interventions), it was 96.4%. Concerning ventricular assist devices, 11 implantations were registered. In 2020 the number of isolated heart transplantations increased to 26, a rise of 44.4% compared to the previous year. Conclusion: This annual registry represents voluntary public reporting by accumulating actual information for nearly all heart procedures in Slovakia, constitutes advancements in heart medicine, and represents a basis for quality management. In addition the registry demonstrates that the provision of cardiac surgery in Slovakia is up to date, appropriate, and fulltime nationwide patient treatment is guaranteed. [ABSTRACT FROM AUTHOR]