Su Zhaoge and I. The current situation congenital heart disease is the most common congenital malformation of human beings, and its incidence accounts for 7‰ to 10‰ of births. China is the country with the highest number of births in the world, with about 150,000 to 200,000 new cases of congenital heart disease each year, and the national capacity for surgical treatment of the disease is about 50,000 to 60,000 cases each year, which is far from the number of surgeries needed. About 1/3 to 1/2 of the children with congenital heart disease are in critical condition in the first year of life, and will die without timely intervention, and even if they pass the difficult time with medical treatment, they will lose the opportunity for future surgical treatment, or increase the risk of surgery and treatment cost. Wuhan Union Hospital Cardiac Surgery Department Hu Zhiwei In the past decade or so, pediatric heart disease diagnosis and treatment has mushroomed in China. Many pediatric medical centers today have entered the ranks of neonatal cardiac surgery. However, there are still gaps between China and international advanced centers, the proportion of patients in the neonatal period or < 3 months in pediatric congenital heart surgery is only 6% to 10% (30% to 50% internationally), the rate of complex heart surgery is 30% to 50%, much lower than international centers (60% to 80%), and the mortality rate of complex heart surgery is 5% to 10% (1% to 3. 5% in international top centers). Almost all congenital heart diseases can be clearly diagnosed through standardized examination, and the results and success rates of surgery are high, with 95%-98% of patients achieving radical cure or symptomatic improvement after surgery. The level of congenital heart disease diagnosis and treatment represents the ability of a unit and a country in disease prevention and treatment. With the rapid improvement of China's economic power, the number of congenital heart disease diagnosis and treatment is increasing, and the early diagnosis and early treatment of critical and complex congenital heart disease should become the goal pursued by clinicians. The concept and measures of early diagnosis and treatment: In 1996, Shanghai Children's Medical Center firstly applied the concept of emergency surgery for critical and complex congenital heart disease in infants and children in China, and operated on critical patients after short-term preoperative preparation, and its surgical mortality rate achieved a good result of reducing from 47% to 4% in internal medicine treatment, and strived to reach 67% of complex heart disease in neonatal period. The rate of neonatal surgery has reached 67%, and the number of neonatal surgery has increased geometrically year by year, with nearly 100 neonatal surgery cases in recent years. The promotion of the concept and practice of emergency surgery nationwide has broken the age of congenital heart disease surgery in China hovering in the age group of 2 to 5 years, which is a big step closer to the international advanced centers. However, the higher risk of emergency surgery increases clinical busy and workload, interferes with orderly medical treatment, prolongs hospitalization time and raises medical costs. The ideal concept and measures are early diagnosis and treatment, and international advanced centers have adopted the concept and measures of secondary and tertiary prevention and treatment, while in China it is only just starting yet to have a scale effect and capacity. The International Center for Women and Infants does ultrasound screening for fetal malformations on every pregnant woman, and the screening rate is almost 100%. According to the current status of modern two-dimensional ultrasound, it is possible to identify complex congenital heart diseases, such as ventricular septal defect/pulmonary atresia with large side branches and hypoplastic left heart syndrome, in 20-week-old fetuses with established cardiac vessels, and to advise early termination of pregnancy for complex congenital heart diseases that are difficult to treat after birth. Fetuses for which postnatal surgical treatment is effective are contacted with the Children's Center before birth, transferred to the hospital immediately after birth, and treated surgically before the onset of critical symptoms through medical and surgical argumentation. Shifting from emergency surgery to orderly elective surgery has increased the success rate and improved medical order. Some centers have been effective in treating neonates with internal medicine to protect their organs first and then operate after the neonatal instability period. 2. Standardized diagnosis and treatment: Standardization of disease diagnosis and treatment is an important measure to improve medical quality. For example, the diagnosis of congenital heart disease is based on medical history, physical examination and laboratory examination, and many units only pay attention to laboratory examination and ignore the complaints, medical history and physical examination. The procedure of examination should be from simple to complex, from non-invasive to invasive examination, and its procedure should be physical examination, 2D ultrasound, MRI or CT reconstruction. Atraumatic cardiac catheterization should only be considered for anatomical problems or for coexisting hemodynamic problems. In the last decade, 5% to 10% of patients at Shanghai Children's Medical School have required cardiac catheterization and cardiovascular angiography as part of this procedure. Currently, simple complete aortic dislocation, complete pulmonary venous reflux, atrial septal defect and permanent arterial trunk can be clearly diagnosed with 2D Doppler ultrasound only. Non-enhanced CT reconstruction of the airway should be added when there are also signs of airway stenosis. At present, cardiac catheterization remains the gold standard for all kinds of examinations, and the author believes that it is premature to replace cardiac catheterization completely with noninvasive examinations in modern diagnosis. The development of minimally invasive and catheter-based interventions is both a development in treatment and a direction. However, physicians or units with no or little cardiac catheterization practice and direct intracardiac surgery use small incisions, thoracoscopic cardiac surgery, and interventions as a starting point for cardiac surgery, and lower-level medical units perform more minimally invasive procedures than even tertiary specialty hospitals, etc. This is also a current misconception in therapeutics. The operation of physicians without specialized technical qualifications will inevitably cause numerous complications to patients. Medical and surgical physicians on the complexity of the patient's condition into the diagnosis and treatment of the level of access system is to improve the quality of medical care, should be first by senior physicians and experienced units practice and summary, the establishment of norms, and then promote. This is the law of social and scientific development, and is also an inevitable measure to reduce patient suffering and shorten the outcome cycle. The access system and consultation norms are evolving with the times, not static, and the revision of norms in different time frames can promote and popularize the original access to surgery by only a few senior doctors (experienced units). The establishment of our organ transplantation and interventional access system is a good start.