As cardiac surgery continues to evolve and save the lives of most cardiac patients, the demand for safer and less invasive procedures has also increased. At the same time, the emergence of teams of surgeons with extensive clinical experience and the use of more advanced equipment have made it possible to reduce the trauma of surgery and improve the quality of life for both cardiac surgeons and patients. Recently, the reporter interviewed an expert in cardiac surgery, Professor Chen Haisheng, member of the Standing Committee of the Second Committee of the Cardiovascular Surgery Branch of the Chinese Medical Association, Vice Chairman of the Thoracoscopic Academic Committee of the Branch, and Director of the Cardiothoracic Vascular Surgery Department of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, to explain the indications and technical requirements of minimally invasive cardiac surgery and to help heart patients and their families understand more about minimally invasive cardiac surgery. It is understood that more than 15,000 babies with congenital heart disease are born in Guangdong Province every year, and there are more than 8 million heart disease patients who need surgery nationwide. Heart disease is a very life-consuming disease that, when left untreated for a long time, results in poor development, short life expectancy and, in most cases, loss of labor force, while once cured, it can be treated like a normal person. With the growing team of cardiac surgeons and the lowering of the cost of heart surgery, heart disease has returned from being an expensive and hard to find specialist disease to a popular level affordable to the working class. As the first non-stop coronary artery bypass surgery in South China and the first minimally invasive small axillary incision intracardiac surgery in Guangdong Province, the chief surgeon. Professor Chen Haisheng introduced that traditional heart surgery uses a longitudinal sternal incision in the middle of the chest, which results in a long incision, large tissue trauma and more bleeding, which not only hinders aesthetics, but also has a long-term negative impact on the patient’s physiology and psychology. In order to avoid these situations, and with the development of cardiac surgery technology, domestic cardiac surgeons are becoming more skilled in cardiac surgery, and newer and more advanced equipment is used in cardiac surgery, minimally invasive cardiac surgery aimed at reducing patients’ surgical pain has emerged. Chen Haisheng said, minimally invasive surgery is the essence of surgery, it has many advantages, such as the best in vivo environment, the smallest physical and mental trauma, the lightest systemic inflammatory response, the smallest surgical incision, the smallest scar, improve the quality of life after surgery, etc., these are the advantages of traditional surgical techniques are unparalleled. Minimally invasive surgery technology has gradually penetrated into the field of cardiothoracic surgery, but minimally invasive surgery requires high experience and equipment, and not all cardiac patients are suitable for minimally invasive surgery. This ratio is much higher than the national average. Since 2008, the Department of Cardiothoracic and Vascular Surgery of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine has been following the trend of world medical development and vigorously carrying out minimally invasive surgical techniques. Some of the techniques have reached the domestic advanced level and are favored by patients. Chen Haisheng said that there are four types of minimally invasive surgery: thoracoscopic minimally invasive cardiac surgery, transthoracic small incision blocking, percutaneous interventional blocking, and small chest incision surgery. Thoracoscopic minimally invasive cardiac surgery Thoracoscopic minimally invasive cardiac surgery is a combination of small chest incision surgery techniques and thoracoscopic technology, so thoracoscopic cardiac surgery techniques are also imaginatively called “keyhole” surgery, the surgical method is to make three 2 cm holes in the left and right chest walls, using the femoral artery and femoral vein cannula to establish extracorporeal circulation. The scope of TV thoracoscopy in cardiac surgery has involved atrial septal defect, ventricular septal defect, mitral valvuloplasty, mitral valve replacement, coronary artery bypass graft, etc. The surgery is done through the thoracoscope under the direct view of TV. After completing the first thoracoscopic minimally invasive cardiac surgery in Guangdong Province in 2004, Haisheng Chen continued his exploration in this field and has completed nearly 400 thoracoscopic minimally invasive surgeries so far, thus becoming an authoritative expert in this field in China. Compared with the traditional median longitudinal sternal heart surgery method, all intracardiac operations are done under the mirror, and the thoracoscope provides a good field of vision, so that the operation can be completed smoothly, with less trauma, less blood loss, less pain, faster recovery, and meets the cosmetic requirements. Transthoracic small incision occlusion Transthoracic small incision occlusion is the abbreviation of chest wall perforation non-extracorporeal circulation atrial septal defect occlusion, which has played an important role in the interventional treatment of atrial septal defect occlusion in recent years. The whole operation is simple and fast, with an average intracardiac operation time of about 10 minutes, a total operation time of about 1 hour, and an average hospital stay of 3-4 days, which is 3-4 days less than that of the median sternotomy. At present, this procedure is mainly aimed at patients with atrial septal defect and myocardial septal defect who cannot be treated by percutaneous interventional occlusion. The advantages of non-external circulation occlusion by chest wall perforation are many: no extracorporeal circulation is needed to avoid the complications of extracorporeal circulation; the surgical incision meets the cosmetic requirements; less pain, faster recovery and lower cost. However, in addition to the extensive surgical experience of the surgeon, the procedure also requires high-end medical auxiliary equipment, such as an esophageal ultrasound machine. Small thoracic incision surgery Among all types of minimally invasive cardiac surgery, small right-sided thoracic incision surgery is the earliest one. The traditional median thoracic incision is very traumatic, bleeds a lot, is prone to infection, leaves a chicken chest and anterior chest scar, which causes physical pain and psychological trauma to some patients. Some patients can be operated by small transthoracic incision, which is located on the anterolateral side of the right chest, with certain concealment and cosmetic effect, and at the same time, avoiding the chicken chest of some children caused by conventional median incision, with small trauma, without cutting the sternum, maintaining the continuity of the thorax, avoiding sternal infection, extensive damage to the anterior mediastinum, deformation of the sternum and fixing foreign body of wire caused by median incision. It also preserves the pathway to repeat cardiac surgery. The main indications for this procedure are: atrial septal defect, ventricular septal defect, partial pulmonary vein ectopic drainage, partial endocardial cushion defect, and mitral valve replacement. Chen Haisheng said, “Minimally invasive surgery is increasingly driving the development of surgery, providing patients with a better postoperative quality of life with higher technical requirements while achieving the same clinical outcomes.” Percutaneous interventional occlusion Interventional treatment for congenital heart disease is a treatment method in which a puncture needle and catheter are inserted along the blood vessel to reach the site of the heart under the guidance of X-rays and ultrasound, and after imaging diagnosis, the lesion is quantitatively and qualitatively analyzed, and then the lesion is blocked, dilated or embolized with special equipment. Interventional occlusion of congenital heart disease is a new treatment method, which is a boon for patients with congenital heart disease who can accept it. It does not require an incision, and patients over the age of 10 can be treated while fully awake without even general anesthesia. The procedure is almost painless, as a needle is inserted into the blood vessel at the root of the patient’s thigh like an infusion, and the whole procedure takes about half an hour, and the patient can be discharged from the hospital after 48 hours of intervention. At present, the First Affiliated Hospital of the University of Chinese Medicine performs interventional treatment for congenital heart diseases such as ventricular septal defect, atrial septal defect, patent ductus arteriosus and pulmonary valve insufficiency. Interventional treatment of congenital heart disease has the following advantages: no incision is required on the back of the chest, and only an unobtrusive needle eye (about 3 mm) is left in the groin. It is less invasive, less painful, and leaves no scars; no need for systemic extracorporeal circulation and deep hypothermia anesthesia during treatment, thus avoiding the occurrence of extracorporeal circulation and anesthesia accidents; no need for blood transfusion, thus avoiding the possible adverse reactions caused by blood transfusion; short hospitalization time and quick recovery after surgery, and can be discharged after 1-3 days of hospitalization. The success rate of various interventions in the department is 100%, with few postoperative complications, and the treatment effect can be as radical as that of surgery. This procedure was not a surgical component in the early stages, but was mainly performed by internal medicine and radiology. Due to the immaturity of the early percutaneous interventional occlusion, the occluder occasionally fell off due to its instability, and there were cases where the heart was pierced during the procedure, which required emergency treatment by surgeons. At the Beijing International Interventional Conference held in May 2004, Chen Haisheng felt that this was an advantageous practice for cardiac surgery, and in September of the same year, he performed the procedure and has since become an expert in the field.