On August 6, 2015, we successfully completed the first case of transjugular vein septal defect closure under intravenous anesthesia with non-tracheal intubation and ultrasound guidance. I believe that with the accumulation of our experience in the field of minimally invasive cardiac surgery, the upcoming fully awake transjugular vein septal defect closure in patients under local anesthesia is entirely possible. Since the first successful ultrasound-guided transjugular vein congenital septal defect closure in June 2015, the Department of Cardiac Surgery of the First Affiliated Hospital of Guangzhou Medical University has continued to advance and make breakthroughs, and recently performed the first non-tracheal intubation atrial septal defect closure for a 19-year-old girl who had just completed her college entrance exams and was about to enter college life. During the whole operation, the patient’s vital signs were stable, and the operation was safe, smooth and perfect. The girl will also have a new and wonderful campus life. With the accumulation of experience, the Department of Cardiac Surgery at GMC has been leading and making breakthroughs in minimally invasive precordial treatment. With the success of this non-tracheal intubation surgery, I firmly believe that the envisioned transjugular septal defect closure under local anesthesia with the patient fully awake is entirely possible. In the future, it is expected that patients will walk into the operating room and out of the operating room by themselves, overturning the previous scenario of cardiac surgery and eliminating the need for intensive care, greatly reducing hospitalization time and costs, and achieving no scars on the body surface.