With the development of cardiovascular surgery techniques and the advancement of medical interventional techniques, multidisciplinary fusion techniques have emerged, such as hybridization procedures, such as interventional treatment of transthoracic precardiac disease, which broaden the indications for surgery, improve surgical safety, reduce patient pain, and provide more options for the treatment of precardiac disease. The following is a brief introduction of several common precardiac diseases with minimally invasive transthoracic treatment. 1.Transthoracic minimally invasive atrial septal defect closure. It is mainly applied to patients with central type small and medium-sized atrial defect (less than 20mm), age above 6 months and weight above 5kg. Generally, a parasternal incision is used to enter the right thoracic cavity, then the pericardial cavity, and a blocker is placed via the right atrium. For suitable patients, it is also possible to enter the right atrium via femoral vein puncture and place the blocker under transesophageal ultrasound guidance. 2. Transthoracic minimally invasive ventricular septal defect repair. It is mainly applied to ventricular defects of more than 3mm and less than 10mm, without combined aortic valve prolapse and incomplete closure, with regular ventricular defect edges, preferably in patients of 6 months and more than 5kg. A small subxiphoid incision is usually used to enter the pericardial cavity and a blocker is placed via the right ventricle. For intracrural ventricular defect with the shunt opening toward the right ventricular outflow tract, a blocker can also be placed via the right ventricle by the left parasternal side; for perimembranous ventricular defect with the shunt opening toward the right ventricular inflow tract or even shunt into the right atrium, a blocker can also be placed via the tricuspid valve by the right parasternal side via the right atrium. 3. Transthoracic minimally invasive arterial catheter occlusion. It is mainly used for simple arteriovenous catheter failure of more than 3mm and less than 15mm. It is especially suitable for patients with thick catheter, combined with pulmonary hypertension, and the risk of traditional ligation surgery or extracorporeal circulation surgery. Generally, the left parasternal side is used to enter the pericardial cavity and place the blocker via the pulmonary artery. 4. Transthoracic minimally invasive pulmonary valve balloon dilatation. It is mainly used in patients with moderate to severe pulmonary stenosis without combined subpulmonary stenosis, poorly developed pulmonary valve and annulus, and severe stenosis of the distal pulmonary artery. In particular, dilatation is most effective in patients with moderate pulmonary stenosis and adequate pulmonary valve annulus, only valve junctional adhesion stenosis, and soft, non-thickened valve leaflets. In some patients with residual stenosis during dilatation or pulmonary stenosis correction, the same can be attempted. A small subxiphoid incision is usually chosen to place a dilating balloon through the right ventricle. Compared with medical interventions for precardiac disease, surgical transthoracic minimally invasive has several advantages. 1. Broadening the indications for surgery. Medical intervention has the limitation of age and access vessels, but surgery does not have these problems, as long as the esophageal ultrasound can be used, it can be done. Furthermore, because of the proximity to the defect or lesion location, surgical operation is more guaranteed. So those children with precordial disease who are younger than 3 years old or at high risk for medical intervention can choose to do surgical transthoracic. 2.No contrast agent and radiation damage. The whole process is done under the monitoring of esophageal ultrasound, which is more reliable. Whether the blockage is successful, whether there is side injury, and how the operation is effective are known intraoperatively, so that the operation becomes safer and more reliable. 3.If the blockage is not successful, the operation can be changed to extracorporeal circulation immediately to avoid secondary anesthesia and trauma; 4.Basically no blood transfusion is needed, no extracorporeal circulation is needed, less trauma and pain, and quick recovery. Of course, the application of any technology should tend to avoid harm, for the current booming surgical transthoracic minimally invasive precordial disease treatment should also strictly grasp the surgical indications, for patients whose indications are not clear enough or blocking failure can still choose traditional extracorporeal circulation surgery.