Recently, we successfully completed another case of ultrasound-guided percutaneous atrial septal defect closure without incision, radiation damage, blood transfusion and extracorporeal circulation, which is truly minimally invasive. Once again, we sincerely thank the cardiac ultrasound room, anesthesiology department, operating room, cardiac surgery ward 2 and cardiac surgery monitoring unit of the First Affiliated Hospital of An Medical University for their support. The conventional treatment for common congenital heart disease includes open-chest surgery and radiation-guided percutaneous interventional occlusion. 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 incision and without radiation, a fourth generation of treatment has emerged: ultrasound-guided percutaneous interventional occlusion. This new method is much 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, and is safe and reliable. 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 treatments complement each other and are suitable for different patients: surgical open-chest direct vision surgery has the widest indications and is suitable for most patients; ultrasound-guided percutaneous interventional occlusion is the least traumatic and is suitable for slightly older pediatric patients, and ultrasound-guided transthoracic occlusion is the most secure and is suitable for younger toddlers. The Second Ward of Cardiac Surgery at the First Affiliated Hospital of Anhui Medical University develops individualized treatment plans according to the characteristics of different patients’ conditions, so that patients can receive safer and more effective treatment.