Abstract： Objective To explore the value of doubly committed ventricular septal defect (DCVSD) closure through a left parasternal intercostal minimal incision under transesophageal echocardiography (TEE) guidance in children.Methods Between August 2014 and December 2016,40 DCVSD children were recruited.The lesions were closed through a left parasternal intercostal minimal incision (≤ 1 cm) and pericardium hanging technique under TEE guidance.TEE was employed for guiding and monitoring the whole procedure.The effectiveness of device closure was assessed by postoperative regular follow-up.Results Among them,39 children underwent complete closure with an operative success rate of 97.5％.The average size of DCVSDs was 3.59 ± 0.92 (2.2-6.0) mm,the average device size 5.33 ± 1.40 (4-9) mm and the average operative duration 45.04 ± 12.81 (18-70) min.Postoperative follow-up period lasted from 6 to 24 months.Seven cases with mild aortic valve prolapse (AoVP) and/or mild aortic regurgitation (AR) were detected preoperatively and pre-existing AR disappeared postoperatively in one patient and remained unchanged in another.There were no cases of perioperative mortality,device deformation or displacement,residual shunt,complete atrioventricular block or valve involvement.Mild pericardial effusion in two patients disappeared during a follow-up period of 3 months.One patient was converted into repairing under direct visualization with a cardiopulmonary bypass because of obvious residual shunt around the occluder.Conclusions Closing DCVSDs through a left parasternal intercostal minimal incsion under TEE guidance in children has the following advantages:avoidance of radiation and sternum incision,procedural reliability and safety,definite efficacy,lower complication rate,minimal incision and simple handling.Wider application of this procedure is recommended.