According to Kohl et al, the use of ultrasound-guided percutaneous puncture for the interventional treatment of fetal congenital heart disease does not appear to have made a breakthrough in the last 15 years, the survival rate of treated fetuses is suboptimal, and the main challenge to increase the chance of functional biventricular repair after birth is to perform interventions earlier in pregnancy. To achieve this goal, the use of ultrasound-guided percutaneous puncture is very limited, and the innovative technique of treatment by fetoscopy, which significantly increases imaging clarity and to some extent overcomes the limitations of conventional treatment, will lead the way in the development of interventional treatment of fetal congenital heart disease in humans, and it brings slightly more fetal membranes than ultrasound-guided percutaneous puncture. The problems of premature rupture and fetal preterm delivery, which are slightly more frequent than those of ultrasound-guided percutaneous puncture, will certainly be overcome with increased operational experience and updated instrumentation. In order to obtain the ideal interventional treatment for congenital heart disease, scholars from various countries have conducted a series of experimental studies on the improvement of interventional methods. Fetal lambs are often used as experimental subjects because their physiological characteristics are similar to those of human fetuses. Kohl et al. exposed the umbilical vessels of fetal sheep by cutting the umbilical cord under the fetal microscope, puncturing the umbilical artery with a puncture needle and feeding a guide wire and catheter, and performing fetal heart catheterization under the monitoring of esophageal ultrasound. Later, Kohl et al. applied the fetoscopic technique to make a longitudinal incision of the chest wall on the fetal lamb’s anterior thorax over the glabella, expose the heart, perform a direct puncture to the left or right ventricle, deliver a guide wire into the ventricle and through the aortic or pulmonary valve under esophageal ultrasound monitoring, and a balloon catheter along the wire and perform aortic or pulmonary valve balloon dilation. jouannic et al. incised the abdominal wall of the pregnant lamb, and after uterine externalization, ultrasound localized the trans The right hepatic vein of the fetal lamb was punctured in utero, and in 10 cases the fetal lamb was successfully punctured and the cardiac catheter was delivered into the pulmonary artery, followed by an arterial catheter to the descending aorta, and in 9 cases pulmonary valvuloplasty was performed. These studies still have a relatively high fetal lamb mortality rate and have not been reported for human fetuses. In 2006, Kohl et al. summarized 16 intrauterine fetoscopic procedures in 13 human noncardiac disease fetuses (six for congenital spina bifida, eight for congenital septal hernia, and two for congenital airway obstruction syndrome) and concluded that fetoscopic techniques are now able to perform procedures by percutaneous puncture of the amniotic cavity, to obtain an ideal fetal position, to perform fetal esophageal cardiac ultrasound and fetal cardiac manipulation, and to It is also possible to insert electrodes into the amniotic cavity to obtain human fetal ECG through the fetal skin with much greater clarity than that of the fetal ECG traced through the mother’s skin; to insert electrodes into the fetal esophagus to obtain human fetal esophageal ECG and to perform fetal refractory The technique allows the insertion of an ultrasound catheter into the fetal esophagus for fetal cardiac ultrasound and ultrasound monitoring of fetal catheter interventions. This is an important experimental milestone for human fetal cardiac interventions, and earlier cardiac interventions based on this technique will be of great benefit in the establishment of a biventricular circulation after birth. The ease of controlling bleeding in the gas environment of this procedure with minimal impact on placental blood flow, the significant reduction in maternal-fetal complications compared to open surgery, and the promise of reducing the few complications that accompany it through the maturation of operating techniques, miniaturization of operating instruments, and the use of a single trocar needle for the procedure. Therefore, Kohl et al. concluded that with these foundations in place, the gradual introduction of fetoscopic techniques into clinical procedures for human fetal cardiac interventions is prudent and feasible. However, the ideal interventional approach to fetal congenital heart disease should minimize maternal-fetal complications. The maternal abdominal wall incision exposing the uterus increases the invasiveness of the procedure, and once the uterus is incised, complications for both mother and fetus rise significantly, preterm delivery is almost inevitable, and the risk of premature rupture of the fetal membranes exists whenever the amniotic cavity is entered, with some degree of damage to the fetal membranes from the fetoscopic technique. Trans-ultrasound guided percutaneous puncture interventional modalities are the least invasive and significantly reduce premature rupture of membranes and preterm delivery (incidence 2-7%). Therefore, the safety of the mother and the risk of preterm delivery must be weighed before resorting to a more invasive procedure. In conclusion, as the number of fetal congenital heart disease diagnoses continues to increase, the prognostic judgment of these fetal congenital heart diseases can influence the choice of treatment strategy in the fetal period. Things like aortic stenosis can develop intrauterine into left ventricular hypertrophic cardiomyopathy and complicate endocardial elastosis, and PA/IVS can cause RVDCC and be trapped in an irreversible situation, to name a few reasons for intrauterine intervention. These experiences gained in the progress of fetal interventions not only originate from the performer but also benefit from the recipient, moreover, they contribute to the accurate grasp and judgment of the pathophysiological features of fetal congenital heart disease. With the development of ultrasound technology, the improvement of operating instruments, the increasing rationalization of patient screening criteria, the continuous improvement of treatment protocols, the continuous understanding of the anatomical and functional characteristics of the fetal heart, and the continuous improvement of other evaluation tools, interventional treatment of fetal congenital heart disease is bound to achieve continuous development.