A small right axillary incision is made from the intersection of the right posterior axillary line and the 4th intercostal space to the curved skin between the intersection of the anterior axillary line and the 6th intercostal space, and the chest is entered through the 4th intercostal space for correction of cardiac deformity (shown below). This area has a weak muscle layer, which allows easy access to the chest cavity and hemostasis with minimal damage. This small incision procedure does not cut off the ribs, maintains the integrity and stability of the thorax, and avoids the chicken chest caused by median open-chest surgery. It enters the chest cavity from the deep side of the pectoralis major muscle between the ribs, away from the breast and the blood vessels and nerves in the thorax, does not affect the development of the breast, and the incision location is concealed, with good cosmetic effect, and does not use steel wire to close the chest, so that future examinations such as MRI are not affected, which is welcomed by the families of children. The right axillary small incision surgery is mainly used for the correction of atrial septal defect, ventricular septal defect and other simpler precordial diseases. Can the tetralogy of Fallot be operated via the right axillary small incision surgery since it is a complex malformation? Or what kind of tetralogy of Fallot can be operated through a small right axillary incision? According to our experience, the right axillary mini-incision is a good indication for the right ventricular outflow tract and pulmonary valve stenosis, while the right axillary mini-incision is not recommended for children with severe pulmonary stenosis, especially in cases with stenosis of the left and right pulmonary arteries, thicker pulmonary side branches, or more complex cardiac malformations.