”Small umbrella to patch the heart hole” (esophageal ultrasound-guided atrial septal defect / ventricular septal defect closure) Ventricular septal defect / atrial septal defect is the most common congenital heart disease, accounting for more than 3 per 1,000 live births after birth. Traditional surgery uses median sternotomy, cardiac arrest, and incisional heart repair, which is highly traumatic and risky, with serious and high incidence of postoperative complications, all requiring blood transfusion and the ability to be infected with diseases. Interventional surgery, although less traumatic, but not suitable for small age, small weight children, and the implementation of interventional blocking surgery under radiation, there is a risk of radiation, in addition, once the operation fails, the need for emergency transfer of patients to the operating room surgery, can not fully ensure patient safety. In recent years, our center has been the first in China to carry out transthoracic minimally invasive occlusion technology for the treatment of septal defects in precardiac disease, which is a perfect combination of surgical and medical interventional treatment methods, with small incisions, small damage, high safety, no radiation damage, strong controllability, short time, no blood transfusion, low cost and fast recovery. The advantages of quick recovery. The procedure can be completed in the operating room, and if the procedure is unsuccessful, it can be changed to conventional surgery on the spot, without the need to transport the patient, thus ensuring patient safety to the greatest extent. Figure 1 Delivery system with blocker Figure 2 Surgical scenario Figure 3 Color flow showing periseptal flow (L→R) Figure 4 Blocker implantation showing disappearance of periseptal flow Figure 4 Conventional surgical incision Figure 5 Blocking incision