Limitations
This study was subject to the typical limitations of a retrospective case series. There were several limitations, including small sample size and differences in the patient populations. Most patients underwent VSD repair in infancy and early childhood, and we excluded patients with severe pulmonary arteria systolic pressure and other concomitant diseases mentioned in the discussion section. As a result, the sample size was small. In addition, while most preoperative characteristics were well matched, there were significant differences in sex and VSD types among the two groups. More females opted for the total thoracoscopic procedure due to the need for favorable cosmesis. We excluded the subarterial or supracristal VSDs in the thoracoscopy group, which led to the vast majority proportion of this type being in the mini-sternotomy group.