Key result
Three-dimensional TTE measured a significantly larger median maximal ASD diameter than 2D TTE (13.0 mm vs 12.25 mm; P<0.001) and strongly correlated with closure device size in children.
Why the study?
Secundum atrial septal defect is the most prevalent type of ASD, and this study aimed to assess it using transthoracic three-dimensional echocardiography in comparison with traditional two-dimensional transthoracic echocardiography.
Does three-dimensional transthoracic echocardiography improve the accuracy of defect size, shape, and rim assessment compared to two-dimensional transthoracic echocardiography in pediatric patients undergoing transcatheter closure of secundum atrial septal defect?
Cohort (n=38)
No
Does three-dimensional transthoracic echocardiography improve the accuracy of defect size, shape, and rim assessment compared to two-dimensional transthoracic echocardiography in pediatric patients undergoing transcatheter closure of secundum atrial septal defect?
Three-dimensional transthoracic echocardiography provides significantly larger and more accurate maximal diameter measurements and better shape delineation of pediatric secundum ASDs than 2D TTE, correlating strongly with transcatheter closure device size and potentially obviating the need for invasive balloon sizing.
Answers are grounded in this paper and cite their sources.
3D TTE may yield larger pediatric ASD measurements correlating with device size; extends prior feasibility data but leaves open whether it should alter clinical workflows.
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.
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Eldeeb et al. (2026) conducted a cohort in Secundum type atrial septal defect (ASD) (n=38). Three-dimensional transthoracic echocardiography (3D TTE) vs. Two-dimensional transthoracic echocardiography (2D TTE) was evaluated on Maximal ASD diameter (mm) (p=<0.001). Three-dimensional TTE measured a significantly larger median maximal ASD diameter than 2D TTE (13.0 mm vs 12.25 mm; P<0.001) and strongly correlated with closure device size in children.
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