Interventional treatment of left-to-right shunt congenital heart disease (congenital heart disease) is a new technique developed in recent years, which is characterized by low trauma, high success rate, controllability, and short patient hospital stay. This study focuses on the similarities and differences between interventional and surgical treatment from the perspective of inflammatory response and myocardial injury. Subjects and methods 1. A total of 60 children, eligible for single left-to-right shunt type of precordial ventricular septal defect (VSD) or atrial septal defect (ASD), were selected for hospitalization from May to December 2004, including 25 cases in the interventional group [9 cases of VSD with defect diameter (4.4±0.9) mm; 16 cases of ASD with defect diameter (15.0±5.3) mm], aged 3.5 to 34.0 ( 10.63±7.58) years old; 35 cases of VSD 22 cases with defect diameter (7.2±2.8) mm; ASD 13 cases with defect diameter (22.8±8.8) mm], age 1.0-15.0 (7.11±4.09) years old; cardiac function grade I-II, no more than mild pulmonary hypertension, and no preoperative pneumonia heart failure in the surgical group. 2. Experimental methods: (1) Main reagents: Interleukin 6 (IL-6) kit was provided by Beijing Beifu Dongya Biotechnology Research Institute. (2) Blood samples were collected preoperatively and 24 h postoperatively, respectively. 2 ml of venous blood was routinely collected without anticoagulation and determined by radioimmunoassay (equilibrium method); granulocyte colony-stimulating factor (G-CSF), creatine kinase isoenzyme (CK-MB) and C-reactive protein (CRP) were collected without anticoagulation; troponin I (CTnI) was anticoagulated by heparin in venous blood and determined by non-homogeneous immunoassay. non-homogeneous immunoassay. (3) Normal values of CK-MB (0-10 U/L); CRP (0-8 mg/L); CTnI (0-0.05 ng/L). 3. Treatment methods: Amplatzer blocker from AGA, USA was used for all interventional groups, local anesthesia for older children, basic anesthesia for those under 10 years old, and general anesthesia if intraoperative esophageal ultrasound was applied; ASD or VSD was repaired by intracardiac direct vision surgery under general anesthesia extracorporeal circulation for surgical groups. 4. Statistical methods: SPSS11.5 was used for all statistical processing The main measurement data were tested for normality, the t-test for independent samples was used to compare the intervention group with the surgical group, the paired t-test was used to compare before and after treatment, and the rank sum test was used for measurement data not conforming to the normal distribution; the χ2 test was used for counting data. All 25 cases in the interventional group completed defect closure with a success rate of 100%; 35 cases in the surgical group completed direct intracardiac surgery under extracorporeal circulation with a success rate of 100%; and there were no deaths in both groups during the perioperative period. 1. Inflammatory response: (1) IL-6: There was a significant increase in the postoperative group compared with the preoperative group (P<;0.01), and it was higher than that of the interventional group (P<;0.05). (2) G-CSF positivity rate: preoperative 4% in the interventional group, rose to 8% after surgery, and increased compared with preoperative P<;0.01); preoperative 11.4% in the surgical group, rose to 31.4% after surgery, and increased compared with preoperative (P<;0.01), the surgical group was higher than the interventional group after surgery, but the difference was not statistically significant. (3) CRP: postoperative group increased compared with preoperative (P<;0.01), and higher than interventional group postoperatively (P<;0.01) 2. Myocardial injury: CK-MB , CTnI postoperative group increased compared with preoperative (P<;0.01), and both postoperative groups were also higher than interventional group postoperatively (P<;0.01) Kirklin, a pioneer of cardiac surgery, had proposed that cardiopulmonary diversion secondary to contact between blood and extracorporeal circulation tubes, the body produces a widespread inflammatory response. IL-6 is produced by T cells, monocytes and other cells, which can induce B cells and hepatocytes to produce immunoglobulins and acute phase proteins, and is an important indicator of the severity of inflammation in the body, and can also be used as an early and sensitive indicator of tissue damage. CRP is a sensitive and reliable indicator of the inflammatory state of the body under normal liver function It is almost proportional to inflammation and tissue damage. In this study, IL-6 and CRP were higher in the postoperative group than in the preoperative and interventional groups, suggesting that extracorporeal circulation surgery can activate the inflammatory response, and the degree of inflammatory response and tissue damage triggered by it is significantly stronger than that of interventional treatment. IL-6 and CRP also tended to increase after interventional treatment, and the triggering of inflammatory response by interventional treatment should not be ignored. The transient edema of the surrounding local tissues caused by the blocker in interventional therapy and the damage to the endothelium during catheter manipulation may be the reasons for the tendency to increase the degree of postoperative inflammatory response, but the specific mechanism needs to be further investigated. CK-MB has a high sensitivity in the diagnosis of myocardial damage, but it is also present in extracardiac tissues such as skeletal muscle, so its specificity is low. CTnI is a new index that has been discovered in recent years for the diagnosis of myocardial damage, and its specificity and sensitivity are both high. The level of CTnI in the circulation is low in normal conditions, but increases rapidly when myocardial injury occurs. In this study, CK-MB, CTnI was significantly higher in the postoperative group compared with the interventional group, indicating that myocardial injury caused by surgery is heavier than interventional treatment. Myocardial ischemia and reperfusion injury caused by extracorporeal circulation may be the main cause. CK-MB and CTnI also tended to increase after interventional treatment, which deserves attention. The damage to myocardium caused by the catheter guidewire during operation may be one of the reasons. In addition, the ASD and VSD blockers have a double disc-like structure, and the waist rides on the defect opening when blocking the defect, and the atrial and ventricular septal tissues around the defect opening are embedded between the two discs, and the blocker rubs against the surrounding tissues with the heart beat, which may also be a reason for myocardial damage. Inflammatory mediators can lead to impaired myocardial cell integrity, increased membrane permeability, and spillage of contents. Therefore, the inflammatory response triggered during the intervention may be responsible for the myocardial enzymatic changes. This study suggests that the inflammatory response triggered by interventional therapy and the resulting myocardial damage are significantly less severe than surgical treatment, providing a laboratory basis for advocating a minimally invasive interventional approach for the treatment of precordial disease.