Heart valve surgery is the only branch among the four main branches of cardiac surgery (pre-cardiac surgery, valve surgery, coronary surgery and macrovascular surgery) that has been least influenced by interventional techniques and is still the most mainstream treatment strategy by surgical means, and the development of minimally invasive valve surgery techniques is the direction that people in medical-related professions have been striving for over the years, and it should be said that it is also the requirement of the present era. So how should we look at the current level of minimally invasive valve surgery technology more rationally and objectively analyze the advantages and shortcomings of the current development of such technology, as well as how the future is the possible trend of true minimally invasive valve surgery, the author would like to discuss only a little personal opinion. In addition, the author would like to explain the fact that the above techniques in minimally invasive heart valve surgery are “minimally invasive” in nature, and the most important trauma to the patient in valve surgery is not from the size of the incision and the incisional approach, but from the necessity of extracorporeal circulation technology in the implementation of heart valve surgery. experience significant alterations in the internal environment, associated effects on multiple organ function, and multiple adverse perioperative states or complications when undergoing surgery. The true “minimally invasive” approach to valve surgery is to reduce the impact of extracorporeal circulation, shorten the duration of extracorporeal circulation, and even abandon the use of extracorporeal circulation. Therefore, objectively speaking: the current minimally invasive valve surgery technology is mainly in the incisional approach from the center open chest to the small incision of the chest wall surgical access improvement, so minimally invasive valve surgery technology should be “small incision valve surgery technology of the chest wall” small incision valve surgery advantages and shortcomings small incision valve surgery technology in recent years at home and abroad The main reason is that the surgical technique of valve surgery is very mature, especially in prosthetic valve replacement, which has become quite popular among medical professionals, and the development and application of related specialized surgical instruments have also reached a high level. With the practical application of small-incision valve surgery technology in clinical practice, relevant clinical research reports and articles at home and abroad have also increased significantly, and more affirmation has been given to the progress of this technology. Recently, domestic professional meetings have shown great enthusiasm for the development and promotion of the small-incision valve surgery technique, and even many websites have participated in active reporting, with many “wonderful” descriptions, such as the original “open-chest surgery”. -The sternum is split open from the center, and the opening is from the bottom of the neck to the abdomen”; now “the opening of minimally invasive surgery is between the ribs, and the ribs are like louvers, and there are openings at birth …… only 50 or 60 ml of blood flow “; what minimally invasive heart surgery “can save 10,000 yuan cost”. How to correctly and objectively understand small-incision valve surgery technology, recognize its advantages and shortcomings, recognize its proportion and status in the mainstream of heart valve surgery is to guide the rational development of small-incision valve surgery technology is an important concept, we as medical professionals to be clear and for the majority of patients is also a transparent a responsibility. In the development of small-incision valve surgery technology should also recognize the reality that in valve surgery due to the small-incision approach makes many patients with diseases that could have been accomplished through repair techniques, but are limited to the lack of small-incision surgical field of view, inconvenience and technical difficulty requirements and give up repair for prosthetic valve replacement. Many valve patients have preoperative atrial fibrillation, and the small-incision approach completely limits the use of dual ablation devices, causing the medical staff to use only unipolar ablation devices that are not as effective, or even to forgo atrial fibrillation ablation therapy for patients undergoing surgery. These ideas of choosing small-incision valve surgery techniques for the sake of “small incisions” often lead to changes in the treatment guidelines and goals for patients with valve disease, resulting in a discounting of some treatment principles, and the author believes that care should be taken to overcome this tendency. Small-incision valve surgery technology initiatives 1, the implementation of small-incision valve surgery technology will first emphasize the learning curve to improve the process, small-incision valve surgery learning curve is determined by a variety of factors, including the ease of surgery, combined with the type of surgery, hospital hardware and software conditions, personal experience of physicians, etc., especially the proficiency of physicians on various types of valve surgery (i.e., the accumulation of personal surgical volume) is the fundamental basis The International Society for Minimally Invasive Cardiothoracic Surgery The expert consensus advice of the International Society for Minimally Invasive Cardiothoracic Surgery is shown below. 2, the development of small incisional valve surgery techniques should emphasize the setting and input of professional surgical instruments and conditions, the application of these professional instruments is not only conducive to the physician to complete the correct operation, but also to the safety of patients; for the past so-called “no conditions, create conditions also on The development concept of “no conditions, create conditions must also be stopped, the work is good at its job must first benefit its tools. In addition, that “small incision surgery can save 10,000 yuan cost” is wrong, the current domestic clinical application of small incision valve surgery technology in the patient treatment cost method usually higher than the corresponding conventional surgery, should make the necessary instructions to patients before surgery. 3, small incision valve surgery technology priority cases (1) simple mitral valve lesion, simple aortic valve lesion, simple tricuspid valve lesion. (2) No significant renal, pulmonary and neurological dysfunction. (3) Better preoperative cardiac function and a heart with some risk-tolerant reserve. (4) Better peripheral vascular condition For repair surgery for rheumatic valve disease, repair surgery for mixed leaflet prolapse, surgery for severe aortic valve stenosis with calcified smaller annulus, and surgery for combined aortic and mitral valve lesions it is advisable to use small incision valve surgery techniques with caution. The “small-incision” approach restricts the use of bipolar ablation devices and the use of unipolar ablation only, which has very poor long-term outcomes for atrial fibrillation and prevents many patients from achieving the goal of simultaneous surgical treatment of atrial fibrillation, thus greatly compromising the quality of treatment that patients should receive; it is recommended that the small-incision approach It is recommended that the small-incision approach technique should be applied primarily to patients with valvular disease who have only “paroxysmal” atrial fibrillation and a small left atrial diameter, so that the use of monopolar ablation devices can still ensure a certain rate of atrial fibrillation cure, while paying attention to the strict closure of the left auricle during surgery will be beneficial to the prevention of long-term atrial fibrillation complications in patients.