Recently, the team of Director Li Yigang of the Department of Cardiology of Shanghai Xinhua Hospital successfully performed a case of trans-oval foramen magnum left auricular occlusion. The patient, Mr. Li, 53 years old, started to experience inexplicable heartburn and sometimes some chest tightness more than three years ago, and was diagnosed with atrial fibrillation, which would slowly improve after rest. He did not pay attention to it at that time, and only recently did he come to the clinic when his symptoms worsened. According to Mr. Li’s attending physician, Dr. Feng Xiangfei, deputy chief physician, the patient had chronic atrial fibrillation with a significantly enlarged heart. During the preoperative preparation, Mr. Li’s examination revealed an extra large left heart ear with a diameter of 3.3 cm and stagnant blood flow in the left heart ear. At the same time, the doctor also found that Mr. Li had an open foramen ovale during the cardiac ultrasound examination. After knowing this situation, Director Li Yigang made a “personalized” surgical plan for Mr. Li – a trans-oval auricular occlusion first, followed by trans-oval atrial fibrillation radiofrequency ablation 3 months later, which can avoid a series of complications that may be caused by atrial septal puncture, and also avoid the most severe atrial fibrillation while waiting for radiofrequency ablation treatment. The mega left auricular occlusion was successfully performed on August 17, 2014. The patient recovered well, was out of bed the next day, and was discharged in 3 days. Director Li Yigang said that in non-valvular atrial fibrillation, more than 90% of the thrombus formation is related to the left heart ear. During an episode of atrial fibrillation, stagnant blood in the left heart ear is highly susceptible to the formation of clots or blood clots, which enter the cerebral vessels, thereby increasing the risk of stroke. As early as the 1930s, it was suggested that closure of the left heart ear could reduce circulating thromboembolism in patients with atrial fibrillation. Foreign treatment guidelines also recommend removal of the left auricle during mitral valve surgery to reduce the risk of stroke. However, surgical left ear closure is too invasive to be used alone in patients with atrial fibrillation who do not require other cardiac procedures, and surgical left ear ligation is difficult to achieve complete closure of the left ear. Left auricular closure (LAAC) is an innovative procedure for stroke prevention in patients with non-valvular atrial fibrillation. It prevents ischemic stroke and systemic embolism by closing the left auricle through interventional means such as percutaneous puncture and catheter route to prevent vascular embolism caused by dislodged blood clots in the left auricle. The key step of the procedure is the atrial septal puncture, but in the opinion of a trained physician specializing in pacing electrophysiology, the procedure is relatively simple and has a very high success rate, and the entire procedure can be controlled in less than an hour or even performed under local anesthesia. At present, a considerable number of cases have been completed abroad, and a certain amount of successful experience has been accumulated, but it is just starting in China. Left-ear occlusion is currently a new global treatment for stroke prevention in patients with atrial fibrillation. There may be more options for patients with atrial fibrillation AF.