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This case series presents two young patients with severe pulmonary valve regurgitation and pectus excavatum. Both patients underwent surgical repair of tetralogy of Fallot and pulmonary valvulotomy, respectively, during infancy and remained under close cardiological monitoring thereafter. After the diagnosis of severe pulmonary regurgitation was confirmed, both were referred to our center for pulmonary valve replacement. Minimally invasive pulmonary valve replacement was performed through a left anterior minithoracotomy. The swift recovery and return to daily activities observed in the presented cases suggest that minimally invasive pulmonary valve replacement through a left anterior minithoracotomy could indeed be considered the procedure of choice for patients with pectus excavatum. [ABSTRACT FROM AUTHOR]