Objective: To evaluate advantages between transesophageal echocardiography guided transthoracic device closure and conventional correction surgery with cardiopulmonary bypass in heart septal defects. Methods: From July 2015 to December 2016, 126 patients with heart septal defects were treated in the First Affiliated Hospital of Anhui Medical University. A total of 79 patients were enrolled in the cohort after removing surgical contraindication; 45 patients received transesophageal echocardiography guided transthoracic device closure (TEE group) and 34 patients received conventional correction surgery (CPB group), respectively. Perioperative clinical parameters (thoracotomy time, time of sternal closure, anesthesia duration, operation time, length of ICU stay, duration of mechanical ventilation, volume of drainage, operative incision lengths, duration of hospital stay, hospitalization expenses, and number of transfusion cases) and postoperative complications were compared between two groups. Results: Success rate of operation was 97.8% in the TEE group and 100% in the CPB group (P>0.05). All clinical parameters were compared between two groups which TEE group was better than the CPB group (P<0.05). The incidence of postoperative pleural effusion in the TEE group was lower than that in the CPB group (4.5% vs 47.1%, P<0.05). No deaths and serious complications occurred during follow-up period. Conclusion: Relative to conventional correction surgery with CPB, transesophageal echocardiography guided transthoracic device closure in heart septal defects was better in minimal invasiveness, recovering time, safety, reliability and so on. It should be actively promoted in clinical practice.