Ventricular septal defect is the most common simple congenital heart defect in cardiac surgery, with an operative mortality rate of less than 1%. The most common surgical procedure is a median sternotomy with extracorporeal cardiac arrest, which can repair most ventricular septal defects alone or in combination with other cardiac anomalies, but the incision is long and superior, which affects the aesthetics and requires clothing with a round neck or higher to cover the upper scar. The surgery requires incision of the sternum, blood transfusion, cardiac arrest, and the risk of post-operative corpus cavernosum. With the improvement of surgical techniques and patients’ requirements for aesthetics, small right axillary incision, femoral arteriovenous cannulation with full thoracoscopic assistance, and small direct view septal defect repair with femoral arteriovenous cannulation have gradually emerged, with hidden incisions that are not easily detected, no sternotomy, less postoperative bleeding, significantly faster postoperative recovery than median incision, and shorter hospital stay and recovery time, but still requiring extracorporeal circulation and blood transfusion. Advances in imaging and materials science have facilitated the emergence of minimally invasive blocking surgery. It is small and low incision, aesthetic, less traumatic, only part of the sternum is incised, low incidence of corpus cavernosum, and beneficial to psychological health without extracorporeal circulation and cardiac arrest, without incision of the right atrium, pulmonary artery, and right ventricular outflow tract, no strain on the internal structures of the heart, avoiding postoperative decline in cardiac function, pulmonary infection, PH-related complications low bleeding, and generally no blood transfusion. Intraoperative esophageal ultrasound monitors in real time whether there is residual shunt after blockage and whether there is any effect on valve function, etc. The operation time is short, fast channel extraction, and postoperative hospital stay is short. It is not restricted by age, and the incision is smaller at younger age. Both the doctor and patient are protected from X-ray radiation. It also deals with some cardiac malformations (atrial septal defect, patent ductus arteriosus, pulmonary valve stenosis), and if blockage fails, surgical repair with extracorporeal circulation can be established by extending the incision, without the need for transport, with high parental acceptance of blockage failure and relaxed surgical indications. However, it also has disadvantages: part of the sternum still needs to be incised, silk or wire fixation is required, hemostasis is more difficult after a small incision, and a drainage tube needs to be placed. To solve the above problems, we carried out left parasternal (substem type, intracrural type and blood flow in the short axis direction toward the pedicle and right ventricular outflow tract) and right parasternal incision (blood flow in the direction of tricuspid valve) ventricular septal defect closure without sternotomy, smaller incision, less bleeding, easier hemostasis, shorter operation time, no risk of corpus cavernosum, and no drainage tube, thus solving the disadvantages of substemal incision. It is worthy of the children’s attention that with more experience, the vast majority of membranous ventricular septal defects (except for those with blood flow biased toward the outflow tract) have also been completed through the left sternal intercostal approach, with nine cases completed in the last two weeks, and only one child with a posterior septal valve type using the inferior sternal incision. Although minimally invasive occlusion surgery has so many advantages, only 50-60% of patients with ventricular septal defects are suitable for this procedure. A cardiac surgeon who has mastered the median incision, thoracoscopic assisted, right axillary incision, and different approaches to occlusion can make a choice that is more in your interest.