Abstract:Objective To evaluate the clinical efficacy of transthoracic closure for congenital ventricular septal defect (VSD) by comparing with percutaneous (transcathete) closure and explore the surgical indications, contraindications and complications.? Methods Retrospective analysis was made on clinic data of 328 pediatric patients with VSD receiving transthoracic closure of VSD and 290 pediatric patients with VSD receiving percutaneous intervention closure of VSD in Central South University Xiangya Second Hospital between April 2012 and April 2016. The surgical success rate, curative effect, complication and failure reason were analyzed in two groups.? Results The total success rate in transthoracic closure group was significantly higher than that in percutaneous closure group［93.6% (307/328) vs 86.6% (251/290), P<0.05] . For the cases of closure failure, the VSD closure was changed into VSD repair under cardio-pulmonary bypass. Postoperative hospital stay and mechanical ventilation time in transthoracic closure group were significantly more than those in percutaneous closure group (all P<0.05). There was no significant difference in hospitalization expenses between two groups (P>0.05). The operation time in transthoracic closure group was significantly lower than that in percutaneous closure group (P<0.05). The new incidence of incomplete right bundle branch block in transthoracic closure group was significantly higher than that in percutaneous closure group (P<0.05). The new incidence of left anterior hemiblock (LAH)in transthoracic closure group was significantly lower than that in percutaneous closure group (P<0.05). There were no significant differences in new incidences of complete right bundle branch block and Ⅲ°atrio-ventricular conductive block between two groups (all P>0.05). There was no significant difference in incidence of early postoperative residual shunt between transthoracic closure group and percutaneous closure group (4.23% vs 3.99%, P>0.05).? Conclusion Transthoracic closure of VSD broadens the indications of percutaneous closure. Early and avoids X ray damage to children and medical care personnel. The mid-term results show that transthoracic VSD closure is a safe and effective treatment method for the VSD with indication.