As a rare congenital heart malformation, coronary artery fistula(CAF) may lead to serious complications such as myocardial ischemia. While conservative management can alleviate symptoms, surgical ligation or interventional occlusion offers a definitive cure.This article reports a unique interventional case. The medical team innovatively employed a probe-assisted delivery system to successfully perform a transthoracic occlusion procedure under real-time guidance exclusively by transesophageal echocardiography(TEE). This case demonstrates that, even in the face of complex anatomical pathways, this radiation-free, precise occlusion technique can achieve safe and effective therapeutic outcomes, providing a new and reliable option for the treatment of CAF.