The heart is a constantly beating blood pump that maintains the constant circulation of blood in the body, and if it goes out of order and strikes, the life of the individual is immediately and seriously threatened, but unfortunately, the heart is another organ that is prone to disease. The prevalence of congenital heart disease among newborns is nearly 1%, a figure that is quite alarming. And the incidence of coronary heart disease, a feature of modern society, rises every year. The incidence of valvular heart disease has also been high, commonly rheumatic heart disease and degenerative valve disease, with rheumatic valve disease predominating in developing countries and degenerative heart valve disease predominating in developed countries. Many heart diseases can only be addressed fundamentally by surgery. But the heart, as a constantly beating vital organ, cannot stop working for a moment. If it is cut open in its usual state, the blood in the body will soon be empty, and besides, the heart is beating constantly, and it is a great problem for surgeons to perform complex and delicate operations on the beating organ. Therefore in the first half of the last century, cardiac surgeons could only do simple operations on the surface of the heart. Intracardiac operations seemed to be an unsurpassed no-go area, but some daring and creative surgeons were quietly trying their revolutionary pioneering work. As a result of the development of cryonics, it was noticed that in a state of hypothermia, the cellular metabolic function of the body decreases and the tolerance of the body to ischemia and hypoxia increases significantly, theoretically, a short period of stopping blood circulation does not have much effect on the body. Dr. Swan first applied it to clinical surgery with success. The method was to put the patient under anesthesia, put him in a pool of ice to cool his whole body, and then open the chest quickly when the temperature dropped to a certain level, blocking the heart circulation, and the operation had to be completed cleanly and beautifully within a few minutes. This is a great challenge to the surgeon’s psychological and technical skills. Therefore this procedure was more limited and many surgeons backed out before such demanding surgical conditions. On the other hand, it was so short that it could only be used for very simple surgeries and it was impossible to perform complex surgeries with it, which forced people to explore new paths. Due to the limitations of cryosurgery, there is an urgent need for cardiac surgeons to go beyond this bottleneck and find a safer and more reliable technique to solve this problem. Many procedures in cardiac surgery require intracardiac operations, most of which are complex and require long operating times, and it is impossible to stop circulation for long periods of time in hypothermic surgery. The ideal solution would be to apply an external circulatory device to replace the patient’s own heart function during surgery, allowing the patient’s own heart to stop working completely and giving the surgeon a quiet and bloodless operating field to perform the operation. The idea is quite imaginative and seductive. Based on Morley Cohen’s experimental research, Lillehei’s creative idea in 1955 to connect the heart and lungs of a healthy person to the patient’s body with a tube, stopping the patient’s heart and lungs during the operation, and having the healthy person’s heart and lungs carry the circulation of both of them, was a success that greatly inspired these courageous pioneers. However, the clinical application was somewhat limited due to the risks this procedure posed to the healthy donor. John H. Gibbon, the father of extracorporeal circulation, was a resident when he was on duty and came across a patient who was dying of pulmonary embolism and thought that if an artificial heart-lung machine could replace her diseased lungs, she would be saved. On March 6, 1953, he used his invention to perform the first successful extracorporeal circulation operation. His first lucky patient was Cecilia Bavolek, a patient with an atrial septal defect, but the next four patients were not as lucky and all died on the operating table, and Gibbon was disheartened. After him, Lillihei took over the improvement of the extracorporeal circulation machine and has been working on the research of artificial lung, he collaborated with Richard H. DeWall and succeeded in developing the bulging lung and applied it in clinical practice. It has become the most fundamental technique in cardiac surgery. With the most basic circulatory support problem solved, surgeons can finally perform complex intracardiac operations in a quiet operating field and even attempt many difficult procedures. Some patients with complex congenital heart disease, in which one or both of the two ventricles normally present are extremely poorly developed and unable to assume their respective functions due to congenital developmental malformations, could not undergo radical surgery, and for a long time such patients had been inaccessible for surgical treatment. Still, the discovery of comparative biologists inspired surgeons that many lower organisms, such as amphibians and reptiles, have two ventricles of the heart that are communicating, equivalent to only one ventricle, so is it feasible in humans as well? People first destroyed the right ventricle in dogs by electrocautery in experiments and found that the dogs still survived, which shows that the function of the right ventricle can be sacrificed in some cases, i.e., people can survive without the right ventricle, but of course the quality of life will be poorer and there may be some complications. This is how the right ventricular patent procedure, also called cavopulmonary connection, was born. The upper and lower vena cava, which would have allowed venous blood to enter the lungs through the right atrium and right ventricle, is connected directly to the pulmonary artery across the right atrium and right ventricle, so that venous blood does not enter the heart and avoids cyanosis from mixing with arterial blood. The two dysplastic hearts are combined and used as one left ventricle to maintain the body circulation. Some patients who undergo this procedure can maintain better cardiac function in a better state after surgery, and some have conceived and had children. Most patients with mild to moderate heart disease can be completely cured after surgery, and their life expectancy and quality of life are not significantly different from those of normal people after surgery. Some patients who are unable to undergo radical surgery because of the severity of their lesions may choose to undergo palliative surgery similar to that described above to prolong their lives and improve their quality of life. However, there is also a subset of patients who are unable to undergo either radical surgery or palliative surgery because their heart lesions are particularly severe or have reached the end stage of the disease, at which point the only option is heart transplantation. With advances in medicine, many organs can be transplanted with great success, and the heart is no exception. The first heart transplant was successfully performed by Bernard, a South African physician. It is now widely available worldwide, but there are still some problems, mainly early and long term rejection. Since there is still a serious problem of lack of donor for heart transplantation, artificial heart was invented in the hope of relieving the problem of lack of donor for heart with artificial heart, but there are still many technical details of artificial heart to be solved, such as the problem of energy supply, human still can’t completely disconnect from the machine, and more complications, so it can only be applied for a relatively short period of time, but this is a promising direction after all. Cardiac surgery has been developed from the beginning to now only more than half a century, compared with similar disciplines, it should be considered a fairly young discipline, but it is also the most closely linked with science and technology, with the rapid development of science and technology, I believe we will be able to see more revolutionary events of cardiac surgery beyond people’s imagination.