Treatment of patients with concomitant patent foramen ovale (PFO), atrial septal aneurysm (ASA), and multi fenestrated ASDs (mfASD) poses many challenges and may need several devices placed across the atrial septum which is more challenging, problematic and expensive. This is done by careful interrogation of the atrial septum by color doppler echocardiography, preferably by transoesophageal or three-dimensional transesophageal echocardiography (3D TEE) at the time of catheterization. We report one case who referred for PFO closures that were found to have an atrial septal aneurysm and multiple small holes. we used one occluder device Uni occlutech to close the PFO and fenestrations that this technique was with high success and without complication.