————– Ultrasound-Guided Percutaneous Interventional Sealing Pan Xiangbin, Department of Pediatric Cardiac Surgery, Beijing Fu Wai Hospital, Beijing, China Atrial septal defect, ventricular septal defect, patent ductus arteriosus, and pulmonary valve stenosis are common congenital heart diseases, and the conventional treatment methods include open-chest direct vision surgery as well as radiation-guided percutaneous interventional sealing. Conventional open-heart surgery requires stopping the heart through a median or lateral incision, then cutting open the heart and repairing the defect by sewing a patch to the heart with a needle. Because of the large trauma and the need to stop the heart, radiation-guided percutaneous interventional occlusion has emerged to completely avoid the shortcomings of the first method, which has the advantages of small trauma and no heart stopping, realizing the treatment of heart disease without surgery, but this method has the risk of radiation damage and failure of occlusion, causing damage to the patient’s thyroid gland, breast, reproductive system and bone marrow, which is typical of a small wound outside and a large internal injury inside. The typical external wound is small and the internal injury is large. The surgeons combined the above two methods and introduced ultrasound technology to create a third method that has the advantages of both: ultrasound-guided transthoracic occlusion, which does not use radiation, no radiation, and the heart does not have to stop, but the trauma is 2 cm long, which is more traumatic than that of percutaneous intervention. In order to achieve the treatment of heart disease without surgery or radiation, we have developed the fourth generation of treatment: ultrasound-guided percutaneous interventional occlusion. This new method is less invasive, with a wound the size of a grain of rice, and replaces the traditional percutaneous interventional occlusion with one that is done under ultrasound guidance, without the use of radiation, without radiation, without special protection, safe and reliable; most patients do not need general anesthesia, local anesthesia is sufficient, and the patient can fully communicate with the doctor during the procedure. Since no radiation is needed, this new treatment method does not need to be performed in the catheterization room, but can be performed in the surgery room. The greatest benefit is that once the blockage fails, it can be immediately changed to open-chest direct vision surgery, which not only can cure the disease by entering the surgery room only once, reducing the burden and pain of patients, but also can guarantee the safety of patients to the maximum extent. The above treatment methods complement each other and are suitable for different patients: direct surgical open-chest surgery has the broadest indications and is suitable for most patients; ultrasound-guided percutaneous interventional occlusion is the least traumatic and is suitable for older pediatric patients; ultrasound-guided transthoracic occlusion is the most secure and is suitable for younger children. The “Surgical Interventional Clinic” in our hospital is staffed by specialists with experience in the four methods of surgery, who can develop individualized treatment plans according to the characteristics of different patients’ conditions, so that patients can receive safer and more effective treatment. The characteristics of the various treatment methods are the following: Surgical Outpatient Clinic Interventional Outpatient Clinic Surgical Interventional Outpatient Clinic Surgical Interventional Outpatient Clinic Surgical Interventional Outpatient Clinic Surgical Interventional Outpatient Clinic Surgical Procedures Frontal and lateral incisions Open-heart surgery Radiation-guided percutaneous interventional occlusion Interventional occlusion combined with surgery Ultrasound-guided percutaneous occlusion Surgical indications Suitable for all types of patients Location and size of the defect Suitable location and size of the defect Suitable location and size of the defect Suitable location and size of the defect Suitable surgical incision Approximately 10 Direct thoracic surgery, third-degree AV block, blocker dislodgement, femoral arteriovenous fistula, retroperitoneal hematoma, contrast allergy, radiation injury Immediate conversion to direct thoracic surgery for failed blocker placement, third-degree AV block Immediate conversion to direct thoracic surgery for failed blocker placement, third-degree AV block