Patient Wang, 11 years ago, began to experience chest tightness and shortness of breath after activity, which improved on its own after rest. Later, this symptom became more and more obvious. Recently, Wang went to Nanjing Chest Hospital and was diagnosed with “congenital heart disease, primary foramen ovale defect”, with a defect size of 2.3 square centimeters, requiring surgery. According to the usual practice, this surgery can only be completed with the traditional median open-chest repair under extracorporeal circulation. However, this procedure requires sawing open the sternum and the incision is 25 cm to 30 cm long, and the patient not only loses more blood, but also suffers from severe postoperative pain. At the end of the surgery, the sternum has to be fixed with a wire closure, and the incision is prone to poor healing, cracking, etc., and may even cause deformity of the sternum. In view of the patient’s extreme fear of traditional heart surgery, Tang Jin, vice president of the hospital, and Zhang Dafa, director of cardiac surgery, decided to perform minimally invasive cardiac surgery under full thoracoscopy. Through meticulous preoperative discussions and preparations, Zhang Dafa made three small incisions of 1 cm to 2 cm in diameter in the patient’s chest, and through these “keyholes”, he used professional thoracoscopic instruments to reach into the chest cavity, put in a miniature endoscope and a miniature scalpel to enter the patient’s heart and repair the defect. The patient had minimal bleeding during the operation, and the operation was successfully completed after 3 hours. The patient started to get out of bed on the 1st day after surgery, and was transferred out of the monitoring ward on the 2nd day. All drains were removed on the 3rd day after surgery and the patient is now under further recovery.