Atrial septal defect accounts for about 10% of the total incidence of congenital heart disease and is a common congenital heart disease in children. Depending on the site of the anatomical lesion, there are three types: first foramen type (primary foramen) defects (10%), second foramen type (secondary foramen) defects (80%) and venous sinus type defects (10%). Solitary secondary foramen ovale septal defects account for 5-10% of all preexisting heart conditions. It is more common in females, with a male-to-female ratio of 1:2. 30-50% of children with precordial disease have a combined atrial septal defect. Although traditional surgery and cardiovascular interventions have been widely used in clinical practice, both modalities have their own advantages and disadvantages. Interventional transcatheter sealing of atrial septal defects has emerged as a perfect method for meeting the indications, completely avoiding the risk of extracorporeal circulation, eliminating pain and scarring, with a short hospital stay and rapid recovery. Secondary foramen ovale septal defect sealing is performed by percutaneous puncture of the femoral vein and implantation of a sealing device into the atrial septal defect via a delivery sheath to restore or improve its hemodynamic status. The Amplatzer blocker was introduced in 1997 in China to treat secondary foramen ovale septal defects. However, this method requires the use of radiation, which can cause varying degrees of injury to both the medical practitioner and the child. Is it possible to achieve a technique that does not require either an incision or radiation? After years of exploration by domestic and international experts, there are occasional reports of transesophageal ultrasound to seal atrial septal defects, but the application of transesophageal ultrasound requires tracheal intubation to prevent asphyxia, which greatly increases the cost and risk of treatment. In children, good sound window conditions allow for a fully guided transthoracic echocardiographic procedure. By replacing transesophageal ultrasound with transthoracic ultrasound, general anesthesia tracheal intubation can be avoided and “no incision, no radiation, no tracheal intubation” can be achieved for the treatment of congenital secondary foramen ovale defects. The medical and nursing staffs who are often engaged in interventional treatment spend thousands of minutes in radiation every year, and it is even more painful that they have to wear heavy lead suits to perform surgical treatment for children. At the same time, the child is also exposed to radiation damage during the procedure. We need to do a better job of protecting children and doctors. Practice is the only test of truth. At present, only a few hospitals in China can independently perform purely transthoracic echocardiography-guided percutaneous closure of atrial septal defects in children with secondary foramina, which has achieved a technological leap forward and benefited both the child and the surgeon. The entire procedure can be performed in a general surgical suite, requiring only an echocardiography machine and eliminating the need to purchase expensive large radiographic equipment. It saves medical costs and is safe and reliable. Indications for this technique: (1) Age not less than 2 years. (2) Central atrial septal defect with increased right heart volume load with a defect of not less than 5 mm. (3) The distance from the edge of the defect to the superior and inferior vena cava, pulmonary veins, and coronary sinus is not less than 5 mm, and the distance to the atrioventricular valve is not less than 7 mm. (4) The diameter of the septum is larger than the diameter of the left atrial side of the blocking parachute used. This technique is a complex technique that requires the operator to be skilled in diagnostic echocardiography and percutaneous interventional techniques. It is an excellent technique that deserves wide dissemination. Children with this type of surgery are usually hospitalized for 3-5 days, usually within one hour including anesthesia, and can be on the floor the day after surgery without incisions, radiation, tracheal intubation, or extracorporeal circulation, and more children will benefit from this minimally invasive procedure.