Abstract： Aim To compare the short-term cardiac structural changes after atrial septal defect repair via different approa-ches.Methods One hundred and four patients underwent atrial septal defect repair were selected and assigned into left lateral mini-incision group,right lateral incision group and median incision group according to the surgical approaches.Cardiopulmonary by-pass time,mechanical ventilation time,postoperative drainage,postoperative length of stay,incision length,intensive care unit time,cardiac structural changes and complications among different groups were compared.Results Compared with median incision group,left lateral mini-incision group and right lateral incision group showed a shorter mechanical ventilation time,postoperative length of stay,and intensive care unit time and incision length,and lower postoperative drainage volume,with statistical difference(P＜0.05).Compared with preoperative conditions,the diameter of the right atrium and right ventricle decreased and the end diastolic diameter of the left ventricle increased in each group after surgery(P＜0.05),and the difference was more significant at 3 months after surgery compared to 3 days after surgery(P＜0.05),while no statistical difference was found among three groups at postoperative 3 months(P＞0.05).The complication rate demonstrated no statistical difference among three groups(P＞0.05).Conclusion The left lateral mini-incision and right lateral incision are better than the median approach for repairing atrial septal defect in the short term,but the appropriate surgical approach should be selected according to the actual situation of patients.