Atrial septal defect is one of the most common congenital heart diseases. The current treatment methods include surgical cardiotomy with direct view defect repair, medical radiography-guided interventional defect umbrella plugging, and surgical transthoracic small-incision ultrasound-guided defect umbrella plugging. The latter two methods are increasingly used. The internal intervention uses femoral vein puncture without incision, but with radiation exposure, the potential harm of which need not be described. Surgical transthoracic wall umbrella plugging, although avoiding radiation exposure, still requires anesthesia and still has a small incision of approximately 2 cm. After accumulating hundreds of experiences with small surgical transthoracic wall incisions, we combined the advantages of medical intervention and surgical ultrasound guidance and innovated a fourth surgical method: ultrasound-guided percutaneous percutaneous atrial septal defect umbrella plugging without anesthesia and radiation exposure. In other words, the procedure is performed with medical interventional devices, via the femoral vein, but without radiation, and is entirely guided by transthoracic ultrasound. The advantages are obvious: no radiation exposure compared to interventional techniques; no general anesthesia and no incision compared to small surgical incisional occlusion.