Real-time transthoracic three-dimensional echocardiography versus two-dimensional transthoracic echocardiography in the assessment of secondum type atrial septal defect in pediatrics

Background: Atrial septal defect (ASD) is among the most frequently encountered congenital heart anomalies, with the secundum type being the most prevalent. This defect results in abnormal blood flow between the pulmonary and systemic circulations. The purpose of this study was to assess secundum ASD using transthoracic three-dimensional echocardiography (3D TTE) and compare its findings with those obtained from traditional two-dimensional transthoracic echocardiography (2D TTE). Research design and Methods: This prospective cohort study included 38 children with secondum ASD amenable to transcatheter closure aged 2 to 18 years who presented to catheterization labs. Results: The maximal size of the ASD was more accurately assessed with 3D TTE and was positively correlated with device size. Conclusions: Three-dimensional echocardiography is a valuable modality for evaluating ASDs, particularly for assessing suitability for device closure and determining orientation. It also provides precise measurements of defect diameter, aiding in selecting an appropriately sized device and potentially eliminating the need for balloon sizing.