Sun Yong, Liao Chongxian, Shu Tao, Yang Qian, Qiang Haifeng, Qiu Feng, Chen Jianghua, Su Maolong (Department of Cardiovascular Surgery, Xiamen Heart Center, Zhongshan Hospital, Xiamen University, 361004, China) [Abstract] Objective: To treat perimembranous ventricular septal defect using non-extracorporeal circulation with minimally invasive occlusion to avoid the damage of extracorporeal circulation. METHODS: In March and May 2006, two patients with perimembranous ventricular septal defect, aged 13 and 21 years old, respectively, were treated with a small incision in the lower median sternum, a purse was made in the bare area of the right ventricular outflow tract, and under the guidance of TEE, a delivery sheath tube with a dilating sheath was passed along the guiding wire into the left ventricle through the VSD, and the blocker was embedded in the VSD for minimally invasive blocking. RESULTS: All 2 cases were successful. The average postoperative hospital stay was 5 days. Postoperative follow-up was 1-2 months with good results, no atrioventricular block occurred, no residual shunt on repeat ultrasound, and no aortic regurgitation. Conclusion: Minimally invasive occlusion is a simple, safe and effective method to treat perimembranous ventricular septal defect. Cardiovascular surgery department of Xiamen cardiovascular hospital, Sun Yong Keywords: ventricular septal defect; perimembranous; minimally invasive; surgical approach