Minimally invasive techniques have revolutionized many areas of surgery, but heart surgery has seen limited progress. We are working to combine ultrasound imaging and robotic manipulation to enable cardiac procedures that minimize patient impacts. One robotic system automatically points ultrasound catheters. This four-DOF robotic system enables panoramic views of internal heart structures and automatically tracks catheters working within the beating heart during minimally invasive procedures. Another robotic system uses real-time 3D ultrasound imaging for dynamic visualization of internal cardiac anatomy through the opaque blood pool. We have developed image processing algorithms that can track tissue structures and surgical instruments in real time, despite poor resolution, acoustic artifacts, and data rates of over 30 million voxels per second. For manipulation of rapidly moving cardiac tissue we have created robotic catheters that can keep pace with fast-moving tissue. This allows the surgeon to interact with the heart as if it was stationary. In vivo validation of this technology in atrial septal defect closure and mitral valve annuloplasty procedures demonstrate the potential for improved patient outcomes.