Embracing a new era of echocardiography-guided percutaneous and non-fluoroscopical procedure for structure heart disease.

The advancement of catheter-based interventional techniques represents a significant evolution in cardiovascular medicine. However, traditional methods that rely on fluoroscopic guidance present considerable limitations including radiation exposure and contrast agent-related risks and the heavy load-caused lead suits. In response, zero or low X-ray emerge, including percutaneous and non-fluoroscopical (PAN) procedure coming as a transformative solution, particularly in treating congenital heart disease, valvular disease, and arrhythmias. These methods minimize the risk of iatrogenic injuries associated with radiative procedures. Innovative PAN procedures and methodologies have been developed to enhance imaging, transcatheter interventions, safety, and accuracy, overcoming previous limitations. By eliminating radiation and expanding accessibility, PAN procedures offer a safe, effective, and economically viable alternative to traditional methods, ushering in a new era of minimally invasive cardiovascular treatment.