Our cardiothoracic surgery department has successfully performed more than 300 cases of direct intracardiac surgery on children with precardial disease using a small right axillary incision. All the children recovered well and were discharged from the hospital. This marks the leading level of minimally invasive cardiac surgery technology in our hospital. The best age for surgery is when the child is 4 months to 18 years old, when the thorax has some space for operation and the ribs are flexible, and the best exposure is through this approach. At present, the main diseases treated include: ventricular septal defect, atrial septal defect, partial pulmonary vein ectopic drainage, partial atrioventricular canal malformation, mild tetralogy of Fallot and other common congenital heart diseases. Under the auspices of Director Zhang Rufang, we have made individualized surgical plans according to the specific conditions of each patient, striving to make the shortest incision and minimize surgical trauma. When many parents of the children saw their “little babies” recover so quickly, they excitedly held the hand of Director Zhang and said, “You not only cured your children’s diseases, but also left no psychological diseases for their future, you are really good doctors! The median sternal incision is the traditional surgical route for cardiac surgery, which can reveal the heart and large blood vessels well, and has been the routine approach for cardiovascular surgery for many years, but there are many drawbacks, such as postoperative drainage, sternal deformity, and unattractive exposure of the incision. With the increasing maturity of cardiac surgery and its related technologies, the success rate of congenital heart surgery has been greatly improved, and the small right axillary incision route can be safely and effectively implemented for the correction of common congenital heart diseases. The minimally invasive and aesthetic nature of the procedure has gradually been emphasized, with the premise of ensuring surgical outcomes, evolving from a median sternal incision to various small incisions. The small right axillary incision pathway is safe, reliable, minimally invasive, aesthetically pleasing, and has been well received by parents of children with congenital heart disease because of the rapid recovery of patients.