Objective:To evaluate the degree of systemic inflammatory response by compare the totally thoracoscopic operation with the conventional open operation to patients with atrial septal defect(ASD). Methods:Total 40 ASD cases were divided into two groups,totally thoracoscopic group(group A,n = 20) and conventional open group (group B,n = 20). In group A,surgical procedures were performed through three lateral-right chest wall holes under thoracoscopy. In group B,the arterial septal defects were repaired in the conventional way. Cardiopulmonary bypass(CPB) time,CPB setup time,aortic artery clamping time,operation time and serum levels of tumor necrosis factor α(TNF-α),interleukin-6(IL-6),intercellular adhesion molecule 1(ICAM-1) and interleukin-10(IL-10) in the two groups were compared. Results: All operation were performed successfully without serious complication. CPB time,CPB setup time,aortic artery clamping time and operation time in group A were statistically longer than those in group B. The serum levels of inflammatory factors(TNF-α,IL-6,ICAM-1,IL-10) in two groups statistically increased after surgery. The serum levels of inflammatory factors(TNF-α,IL-6,ICAM-1,IL-10) in group A were statistically lower than those in group B. Conclusion:Repair of ASD totally under thoracoscope ameliorats systemic inflammatory response. It is technically feasible,and safe.