A system for manipulating a heart during cardiac surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. A component of the system engages the heart with a head of a heart positioning device, repositions the heart into a displaced position and maintains it in the displaced position while the heart continues to beat with substantially unabated and uninterrupted cardiac output. A select portion of the heart in the vicinity of a target area is immobilized to facilitate a surgical procedure to be performed at the target area. One form of the system can be used in minimally invasive surgery.