ObjectiveTo systematically review the efficacy and safety of minimally invasive transthoracic device closure versus conventional surgical repair in the treatment of atrial septal defects.MethodsWe systematically searched EMBASE, PubMed, the Cochrane library , CNKI, and Wanfang, using “atrial septal defects, Cardiopulmonary bypass, surgical repair, and transthoracic device closure” for retrieval words from inception of each database to September 1st, 2017.The RevMan 5.3 software was used in data processing.ResultsTotal 8 studies with 1018 cases were enrolled in this study.Meta-analysis results showed that the operation success rate, the incidence of postoperative complication, the incidence of major complications, and the mortality rates were similar in both groups.The incidence of arrhythmia（OR=0.43，95%CI：0.28～0.66，P=0.000 1）, the operation time（OR=-74.66，95%CI：-81.28～-68.04，P<0.000 1), ICU stay（OR=-74.66，95%CI：-13.25～-68.04，P<0.000 1）,the total length of hospital stay（OR=-2.88，95%CI：-4.28～-1.47，P<0.000 1） in minimally invasive transthoracic device closure group were lower than that in conventional surgical repair group with statistical significance.However, the incidence of postoperative residual shunt in minimally invasive transthoracic device closure group （OR=2.69，95%CI：1.10～6.58，P=0.03) was higher than that in conventional surgical repair group with statistical significances.ConclusionMinimally invasive transthoracic device closure can treat ASD safely and effectively.Compared with conventional surgical repair, it has advantage of less operation trauma, faster recovery, and less hospital expense.