Atrial septal defect (ASD) is one of the most common congenital heart diseases in cardiac surgery, which used to be mostly repaired by a median transthoracic incision with a long incision, large scar, trauma, and the need for extracorporeal circulation, cardiac arrest, and blood transfusion. Figure 1, 8 years old, male Figure 2, 5 years old, female As the demand of patients and families for aesthetics increased, small right axillary incisions and thoracoscopic-assisted atrial septal defect repair emerged, and like the median incision, they still required extracorporeal circulation, cardiac arrest and blood transfusion, but the incisions were aesthetically pleasing and concealed (right axillary incisions are generally 6-8 cm. 3 thoracoscopic incisions of 2 cm, 2 cm, and 3-5 cm, respectively, but required a (a 3cm incision for femoral arterial cannulation) Figure 3, 11 years old, female Figure 4, adult, female Internal transcatheter interventional occlusion completely avoids the above disadvantages by having only one puncture point at the thigh without extracorporeal circulation, cardiac arrest and blood transfusion, but is limited by the diameter of the femoral artery and requires an age of 3 years or older for the procedure. Moreover, and more importantly, this method carries the risk of radiation damage and failure of blockage, causing damage to the thyroid, breast, reproductive system and bone marrow of the patient, especially in children in a period of rapid growth and development, with “a small wound outside and a large internal injury inside”. Surgeons combined the two methods mentioned above and introduced ultrasound technology to create a minimally invasive transthoracic occlusion. This method is not restricted by age, does not use radiation, has no radiation, does not require extracorporeal circulation, cardiac arrest and blood transfusion, but has a 2-3 cm incision next to the right sternum or under the right axilla, which requires access to the chest, incision of the pericardium and suturing at the atrium, which is more traumatic than percutaneous intervention. Figure 5 Figure 6 To better address the shortcomings of the above surgical methods, ultrasound-guided percutaneous interventional atrial septal defect closure is carried out, with only one puncture site in the thigh, without radiation and without extracorporeal circulation, cardiac arrest and blood transfusion. The procedure is performed in the surgical suite, which allows for maximum patient safety. Not one specific surgical approach is appropriate for all patients, and each surgical approach has its indications. Surgical open-heart direct-view surgery has the widest range of indications, especially in combination with other intracardiac malformations. A small right axillary incision is suitable for simple atrial septal defects weighing more than 10 kg, younger than 14 years of age, and which cannot be occluded. Thoracoscopic-assisted incision is suitable for patients weighing more than 15 kg, especially for patients over 10 years of age. Minimally invasive transthoracic occlusion is suitable for atrial septal defects with secondary foramen ovale at an age of less than 3 years and a weight of less than 15 kg. Ultrasound-guided percutaneous atrial septal defect closure is suitable for patients older than 3 years old and weighing more than 15 kg with secondary foramen ovale. These treatment methods are well established in GMC, and we can develop individualized treatment plans according to the characteristics of different patients, so that patients can receive safer and more effective treatment.