Objective: To investigate the safety and feasibility of ultra-fast track anaestheisa(UFTA) in patients undergoing total thoracoscopic closure of congenital heart defects. Methods: Clinical and operational data of 286 patients were retrospectively analyzed. Atrial or ventricular septal defects were closed via a totally thoracoscopic approach. Summary the feature of anesthesia, operation and cardiopulmonary bypass. The patients were divided into two groups: UFTA group and traditional group according the time of extubation. The general characteristics, clinical and operation data, outcomes of the patients were compared between two groups. Results: All the operations were successful and all patients were alive. Immediate extubation in the operating room was performed in 220(76.9%) patients. A delayed extubation was completed in the intensive care unit in the remaining 66 (23.1%) patients. There was no significant difference in the age, sex, body weight, or type of congenital heart defect between two groups. However, more patients in the traditional group had severe preoperational pulmonary hypertension. The cardiopulmonary bypass time, aortic cross clamp time, total duration of the surgery were shorter and the dosage of fentanyl used during the surgery was lower in the UFTA group. In UFTA group, the rates of postoperative sedation and analgesic, the ICU stay , postoperative hospital stay time were shorter than those in traditional group. There was no significant difference in the rates of the clinical outcomes such as volume of chest drainage, pulmonary atelectasis, blood transfusion between two groups. Conclusion: Ultra-fast track anesthesia was feasible and safe in the majority of patients undergoing totally thoracoscopic closure of ASD or VSD. Preoperational pulmonary hypertension, duration of the surgery, and the dosage of fentanyl used for were the influence factors for UFTA .