Objective: To explore the feasibility and advantage of the transthoracic occlusion surgery of atrial septal defect(ASD)under the guidance of transesophageal echocardiography(TEE).Methods: In experimental group,fifty-four patients with ASD were examined by transthoracic echocardiography and TEE from September 2009 to August 2014 in our hospital. In control group, thirty-one patients were eligible for repairing of ASD under cardiopulmonary bypass. For the comparative study, we used SPSS 16.0 to study these indicators: the operation time, the breathing machine auxiliary time, the postoperative hospitalization days, the wound length and psychological recognition.Results: In experimental group,the operation time was (81.13±15.91) min, the breathing machine auxiliary time was (193.67±72.74) min, the wound length was (3.41±1.13) cm, the mean postoperative hospitalization days were (3.37±0.49) days. All of them had a good psychological recognition. In control group, the operation time was (109.13±18.19) min, the breathing machine auxiliary time was (425.06±40.67) min, the wound length was (10.78±1.37) cm, the postoperative hospitalization days were (9.61±1.69) days. The psychological recognition:8 patients were good, 10 patients were neutral,13 patients were poor. The results in experimental group were better than those in control group(P<0.05).Conclusion: The transthoracic occlusion surgery of ASD under the guidance of TEE is a safe and feasible operation style,it can reduce operation time, breathing machine auxiliary time, the postoperative hospitalization days and the costs,meet a cosmetic requirement and get a good psychological recognition.