ObjectiveTo summarize the experiences of minimally invasive occlusion of ventricular septal defect (VSD) via small chest incision. MethodsWe retrospectively analyzed the clinical data of 131 infants with VSD in Hebei children's Hospital between March 2013 and September 2014, including 83 patients with perimembranous VSD, 24 patients with membranous aneurysm and 24 patients with intracristal VSD. There were 63 males and 68 females with a mean age of 35.28±29.22 months and a mean body weight of 14.56±7.47 kg. Before surgery, a multiple-section transthoracic echocardiography (TTE) was employed to evaluate various parameters of the VSD. Under general anesthesia, a small incision was made to expose the right ventricle. Under TEE guidance, proper device was delivered and deployed to close the defect. Patients also received postoperative following-up by transesophageal echocardiogram (TEE) at regular intervals. ResultsOne hundred twenty-nine patients were successfully performed operation. Two patients were converted to perform traditional surgical closure with cardiopulmonary bypass (cPB). concentric devices were used in 52 patients and eccentric devices were used in 77 patients. During the following-up (1-12 months) period, complications occurred in three patients. Massive pericardial effusion appeared and disappeared after pericardicentesis in one patient. The occlusion device was dislocated in the next day after operation and took out by cPB operation in one patient. There was an asymptomatic residual shunt at 1 mm in one patient. ConclusionThe minimally invasive occlusion of VSD via small chest incision is a safe and effective treatment. It should be encouraged to use in the clinical practice.