Since AmplatzerK adopted the Amplatzer blocker to block ASD in 1997, percutaneous interventional blocking has become the main treatment modality for secondary foramen ASD due to the advantages of no surgical incision and no need for extracorporeal circulation. However, percutaneous interventional occlusion has the following disadvantages: 1) large radiological equipment is required, there is radiation damage, and it is restricted by age, generally used in patients over 2 years old; 2) the delivery system is long and poorly manipulated; 3) the sheath is nearly parallel to the ASD plane, which makes it difficult for large ASD occluders to snap into place and easy to dislodge and shift. Esophageal ultrasound-guided transfemoral vein interventional occlusion avoids the problem of radiation injury, but still has various defects of X-ray mediated percutaneous occlusion. Transthoracic occlusion is a new approach that has emerged in the last decade, which does not require exposure to X-rays, is not age-restricted, has better occlusion results in large ASDs, has a short delivery system, is flexible in operation, and delivers the sheath tube perpendicular to the ASD plane; however, this procedure involves access to the chest cavity for operation and has a 1.5-50px chest wall incision. Ultrasound-guided ASD occlusion via the adjustable curved sheath of the right internal jugular vein is a new surgical approach with the following features: 1. No large X-ray equipment is required and there is no radiation damage. 2.TEE guidance, for the heart anatomical structure and delivery sheath tube shows clearly. 3.The internal jugular vein is thicker than the femoral vein and can accept larger sized sheaths, and ASD can be blocked even in young children less than 1 year old. 4.Adjustable curved sheath head end can be precisely adjusted within 0~180°, and by rotating the sheath and moving the depth of the sheath, it can make the head end of the sheath perpendicular to the septal plane and located in the center of ASD. 5.The delivery path is short and easy to operate, and the sheath tube enters the ASD directly without using the guidewire and sheath core, which will not damage the intracardiac structures. 6.For large ASDs, because the sheath tube is perpendicular to the ASD, it can achieve the same effect as transthoracic occlusion. 7. This procedure can be performed in a general operating room, and once the blockage fails, the procedure can be immediately transferred to extracorporeal circulation. In conclusion, ultrasound-guided ASD occlusion via the adjustable curved sheath of the right internal jugular vein is a new procedure with simple operation, slight trauma, wider indications and less complications, which has achieved satisfactory clinical results and has obvious advantages compared with traditional percutaneous interventional occlusion and transthoracic occlusion of ASD. This procedure does not require special equipment and can be done in an ordinary operating room, which is easy to promote and has a broad application prospect.