Congenital heart disease is the most common type of congenital malformation, accounting for about 28% of all kinds of congenital malformations. According to statistics, 150,000-200,000 new children with congenital heart disease are born in China every year, with an incidence rate as high as 0.8%. Only a few types of congenital heart disease can heal spontaneously, while other types will gradually increase in complications and worsen as they get older. Ventricular septal defect is one of the most common types of congenital heart disease. For the treatment of ventricular defect, the main treatment methods are direct visual repair under extracorporeal circulation, percutaneous endoscopic interventional closure and transthoracic small incision minimally invasive ventricular septal defect closure. Direct visual repair under extracorporeal circulation requires intraoperative cardiac arrest, so the operation is very traumatic and the patient’s postoperative recovery is slow. At the same time, many patients are reluctant to undergo the procedure because of the impact of abnormal circulatory perfusion on the lungs, liver, kidneys and nervous system, and the high number of postoperative complications. In contrast, the indications for percutaneous endoscopic interventional occlusion are more limited, and the operation is complicated. Patients and physicians are exposed to X-ray radiation for a long time, and it is difficult to deal with unexpected situations, which makes many patients unable to accept this minimally invasive method of treatment. More importantly, the damage to the vessel wall and myocardium during the procedure cannot be avoided, and the catheter path is far away after the intraoperative track is established, making it difficult for the operator to operate and the control of the guidewire is poor, making the accuracy reduced. Especially for younger children, the vessel wall is thin and the lumen is fine, if the intracardiac defect is large, then the blocker cannot reach the defect site through the appropriate sheath, which may easily lead to treatment failure. In recent years, ultrasound-guided minimally invasive transthoracic septal defect closure with a small incision has expanded the indications for septal defect closure. A minimally invasive incision of about 3 cm under the sternum is made to enter the mediastinum and reach the heart, and a tissue spreader is used to reveal the operative field, and under the guidance of esophageal ultrasound, the blocker is firmly fixed to the defect in the heart by a guide wire to completely seal the defect. Transthoracic small incision minimally invasive septal defect closure avoids the huge damage caused by sawing open the sternum and extracorporeal circulation, ensures the integrity of the thorax, greatly reduces postoperative pain and postoperative complications; moreover, the whole procedure is free of X-ray radiation and does not require the long-distance operation of the guidewire in the blood vessel, which has the advantages of small trauma, short operation time, fast recovery and good cosmetic effect, and is an important development direction for the treatment of precordial heart disease in the future.