In recent years, with the continuous improvement of people’s living standard, patients and their families no longer meet the requirements of cardiac surgery only for the cure of the disease, but also for the quality of postoperative recovery and the aesthetic appearance of the incision, which has directly contributed to the development of minimally invasive cardiac surgery. This has directly contributed to the development of minimally invasive cardiac surgery. Minimally invasive cardiac surgery, with its advantages of short operation time, quick recovery and aesthetic appearance, has greatly reduced the psychological burden of patients and is welcomed by them. Types of minimally invasive cardiac surgery 1. Minimally invasive small incision surgery Small incision surgery is a significant reduction of the incision in the chest surgery, but most of them do not change the original surgical path and are still performed under direct vision through the eyes of the surgeon. Small incision surgery does not require special auxiliary equipment and is mostly performed using the right axillary, upper sternal, parasternal, complete transection of the sternum, lower sternal, right sternal window and left sternal window approaches. Compared with the traditional surgery, it has the advantages of faster recovery, less damage, less bleeding and can perform a variety of cardiac surgeries. The annual operation volume of pediatric heart center of Anzhen Hospital is nearly 3000 cases, and 90% of simple atrial and ventricular defects are operated by right side minimally invasive small incision. 2.TV thoracic cardiac surgery Thoracoscopic cardiac surgery is a complex cardiac surgery done in the chest cavity with the aid of TV image surveillance by using modern TV camera technology and high-tech surgical instruments and equipment to make three 1-2 cm “keyholes” in the chest wall and enter the surgical instruments through the keyhole-sized incision. The operation is performed with a “lumpectomy”, which is the same as extending the surgeon’s eyes into the patient’s chest cavity to perform the operation. The superiority of thoracoscopic cardiac surgery is that it minimizes surgical trauma, minimizes postoperative pain, shortens postoperative recovery time, lowers surgical costs, and meets cosmetic requirements while ensuring surgical results. Minimally invasive cardiac lumpectomy has clear surgical indications, such as: simple mitral valve lesions, tricuspid valve lesions, left atrial mucinous tumors, etc. It also includes some simple congenital heart diseases, such as atrial and ventricular septal defects. This surgery is not suitable for patients with complex multivalvular disease, complex congenital heart disease, complex coronary artery disease with multi-branch lesions, patients with poor heart function and patients with chest adhesions. 3.Robotic heart surgery is not yet carried out on a large scale in China. The scope of robotic coronary surgery includes artificial coronary artery anastomosis by robotic extraction of internal mammary artery, small incision or median open-chest stop-beat or non-stop-beat bypass grafting up to completely thoracoscopic coronary artery bypass grafting. Patients undergoing robotic surgery have significantly less transfusion and hospitalization time than open-chest patients, but at significantly higher cost. Although most patients who need cardiac surgery want minimally invasive surgery, minimally invasive surgery can only be performed if certain surgical conditions are met, and depends on the patient’s condition. For heart surgery, the purpose is to cure the disease, the cost should be appropriate, the risk of surgery should be small, and the main thing is to be skillful and precise, fast, for example, heart valve replacement surgery, the traditional method of cardiac arrest only takes 30 to 40 minutes, but if the technique is not skilled minimally invasive surgery, it may take one or two hours, too long to stop the heart will be damaged. Therefore, although minimally invasive cardiac surgery is good, it still cannot widely replace classical cardiac surgery: minimally invasive cardiac surgery has not yet been standardized, surgical instruments are constantly being improved and perfected, and the requirements for the operator are high, who must have extensive experience in cardiac surgery, strict and systematic training, proficient surgical skills, and the ability to deal with minimally invasive surgery quickly once it goes bad. If other lesions are found during the surgery, or if the minimally invasive surgery fails, salvage methods can be taken. Therefore, a strong and large hospital should be chosen for this type of surgery.