Abstract: AIM:To compare the complications and long-term quality of life of heart surgery by video-assisted thorascopy and mini-right thoracic incision. METHODS: From January 2009 to December 2009, ten patients diagnosed as having atrial septal defect or ventricular septal defect or simple mitral lesion were assigned by double-blind method to two groups: video-assisted thorascope (VAT) group (n=5) and mini-right thoracic incision (MRTI) group (n=5). Complications and long-term quality of life postoperatively were compared between groups. RESULTS: Complications in the VAT group were significantly less than those in the MRTI group. Quality of life of the VAT group was significantly better than that in the MRTI group. CONCLUSION: Video-assisted thorascopic heart operation is the most optimal approach for patients with atrial septal defect or ventricular septal defect or simple mitral lesion.