The median thoracic incision completely splits the sternum, revealing the heart and large blood vessels well, and has been used as a routine approach for cardiovascular surgery for many years, but due to the large trauma of splitting the sternum, postoperative sternal deformity and other complications, and the obvious median skin scar, which affects the aesthetics and has a negative impact on the patient’s psychology. With the improvement of people’s living standard, there are higher requirements not only for the safety of surgery but also for the trauma of surgery and keeping the aesthetic appearance. Atrial and ventricular defect repair, triple atrial heart, pulmonary vein ectopic drainage, mitral valve replacement, aortic valve replacement and radical treatment of tetralogy of Fallot can be completed through small incisions. Pang Yunfeng of the Department of Cardiac Surgery, Qinghai Cardiovascular Hospital We use a small right thoracic incision, because it does not split the sternum, does not cut the ribs, and avoids the female breast, not only the intraoperative trauma is small, fast recovery and hidden incision scar, in addition, the operation is close to the upper edge of the ribs into the chest to avoid damage to the intercostal artery, basically no obvious bleeding, postoperative chest fluid is significantly reduced compared with the median incision, the drainage tube is removed early, which can reduce the chance of infection in the chest cavity. Postoperative 2-3d can get out of bed, and the hospital stay is significantly shortened. For some simple cardiac surgery, such as secondary foramen ovale septal defect and ventricular septal defect, it is easier to complete with this incision, while for the unblocking of right ventricular outflow tract stenosis and the repair of sub-stem ventricular septal defect, it is more demanding for the operator. We use a piece of ice saline gauze under the heart to pad up the heart and expose the right ventricular outflow tract with a slight traction, which can also be done, but it is more difficult. A small right lateral incision with a fourth intercostal approach is appropriate to fully expose the superior and inferior vena cava, ascending aorta, right atrium, and right ventricle, and can be used for cardiac surgery traditionally performed through the right atrium, septum, and left atrium incisions.