Traditional cardiovascular surgery mostly uses a median sternal incision and partly uses a left posterior lateral chest incision. As the safety of cardiovascular surgery continues to improve, the aesthetics of the intraoperative trauma incision and other issues are gaining increasing attention, and in recent years minimally invasive small incision surgery has gradually become popular among the majority of aesthetic patients. Traditional valve replacement surgery uses a median open-chest surgery to replace the valve, the latest treatment is a small incision heart valve replacement surgery, this treatment in the chest wall only keyhole-like small hole for surgery, the patient trauma is small, fast recovery, surgical safety, chest wall without large incisions and beautiful. Minimally invasive small incision means that the length of the surgical access incision is 6-10 cm and the incision is located in a relatively hidden part of the chest. 1.Small right thoracic incision 1.1.Small right axillary incision：Take the second rib intersection of the right mid-axillary line and the fifth intercostal intersection of the anterior axillary line to make a 5-9cm incision, the length depends on the age and height, and enter the chest in the fourth rib of the anterior axillary line, with less muscle damage in the chest entry. It is generally used for children under 15 years old, and the thoracic cavity is relatively small in children. The rib cage is flexible, so it is safe to perform some simple congenital heart malformations, such as the repair of atrial septal defect and ventricular septal defect. It is also possible to perform surgery for triple atrial heart, pulmonary vein ectopic drainage, mitral valve insufficiency repair and valve replacement. This incision should not be used for children with severe pulmonary hypertension with pulmonary dysplasia or pulmonary infection, children born <4 months old with severe pulmonary hypertension, children with complex congenital heart malformations such as tetralogy of Fallot with very poor pulmonary vascular development, or children with unclear preoperative diagnosis. 1.2, right anterolateral incision: From the axilla to the 5th rib of the midclavicular line, make an arcing incision, about 8-12 cm long. In women, make a skin incision along the lower edge of the breast, cut along the anterior serratus and the pectoralis major muscle, and enter the chest through the 3rd or 4th intercostal space. The symptoms should be the same as before. In adults, the thorax is larger, less elastic, and the operative field is deeper, so it is generally appropriate to use the anterolateral incision. 2. Small left axillary incision: The specific site is the same as the small right axillary incision, but it is located on the left side and is used for the surgical treatment of unclosed arterial catheter. After complete hemostasis, the chest drain may not be placed, which greatly reduces the postoperative pain of patients. 3. Small lower sternal incision: the skin incision is located in the lower 1/2 of the sternum to the subxiphoid process, the incision is about 7-10 cm long, splitting the lower 1/2 to 2/3 of the sternum, and can be extended upward to open the chest if necessary if it is difficult to reveal, which is relatively safe. The incision has small trauma, less bleeding, and the stability of the thorax is not completely destroyed, which is conducive to the recovery of respiratory function after surgery. The small lower sternal incision is suitable for the repair of atrial septal defects and ventricular septal defects. It is also able to perform surgery for triple atrial heart, pulmonary vein ectopic drainage, mitral valve closure insufficiency repair and valve replacement. In conclusion, the characteristics of small incision surgery are beautiful incision, addiction, small trauma, less bleeding, fast recovery, good healing, less deformity, less cost, etc. However, for patients with complicated conditions or adults with obesity and flat chest, they must be carefully selected according to their conditions and doctors' opinions.