ObjectiveTo summarize our experience of right axillary straight mini-thoracotomy for surgical treatment of common congenital heart diseases in infants. MethodsWe conducted a retrospective analysis of 369 infants undergoing open heart surgery through right axillary straight mini-thoracotomy in the 153th Central Hospital of People's Liberation Army from April 2009 to April 2013. There were 191 males and 178 females with their mean age of 8.2±3.1 months (range, 3-12 months)and body weight of 7.8±4.5 kg (rang, 4.5-11.2 kg). Surgical procedures included ventricular septal defect (VSD)repair in 290 patients, atrial septal defect (ASD)repair in 16 patients, VSD and ASD repair in 34 patients, VSD repair and mitral valvuloplasty in 4 patients, valvotomy for pulmonary valve stenosis (PVS)in 9 patients, ASD repair and valvotomy for PVS in 6 patients, correction of partial anomalous pulmonary venous connection in 4 patients, and correction of partial atrioventricular canal defect in 6 patients. ResultsSix patients (1.6%)died postoperatively. Postoperative complications included right atelectasis in 3 patients, right pneumothorax in 2 patients, pneumonia in 16 patients, incision fat liquefaction in 12 patients, third-degree atrioventricular block in 1 patient, cerebral air embolism in 1 patient, and reexploration for bleeding in 3 patients. A total of 295 patients were followed up for 6 to 12 months after discharge. Residual VSD shunt was found in 4 patients, and mild mitral regurgitation was found in 2 patients. ConclusionClinical outcomes of right axillary straight mini-thoracotomy during open heart surgery are satisfactory for infants with common congenital heart diseases, but strict indications and skillful surgical techniques are needed.