Symptomatic aneurysm of ductus arteriosus in neonates

Asymptomatic congenital ductus arteriosus aneurysm in a newborn: Case by approach

A ductus arteriosus aneurysm is a rare congenital lesion with a localized saccular or tubular dilation of the ductus arteriosus. This lesion usually appears in all ages. Some case reports suggest the most common age of diagnosis is less than 2 months. We reported a case of an asymptomatic ductus arteriosus aneurysm in neonates. Echocardiography at 2 days of age revealed a tubular dilation of the ductus arteriosus connected to the pulmonary artery. Computed tomography angiogram showed a ductus arteriosus aneurysm with thrombus at the pulmonary end. It resolved spontaneously in the six months of life without serious complications.

The Many Faces of Neonatal Ductus Arteriosus Aneurysms: Multimodality Imaging with an Emphasis on CT and MRI Appearance

Neonatal ductus arteriosus aneurysm (DAA) is a rare abnormality that is typically diagnosed at fetal third trimester or early postnatal echocardiography. While echocardiography is usually adequate for diagnosis and clinical decision-making, cross-sectional imaging, including CT or cardiac MRI, may be necessary to clarify the diagnosis or delineate associated complications. Severe complications include thromboembolism, infection, compression of adjacent structures, airway erosion, and aneurysm rupture. This imaging essay reviews the pathophysiology and depicts the spectrum of cross-sectional imaging appearances of neonatal DAAs. Most neonatal DAAs will spontaneously regress and can be managed conservatively. Keywords: CT, MRI, Cardiac, Aneurysms, Congenital Supplemental material is available for this article. ©RSNA, 2021.

Thrombosis of isolated ductus arteriosus aneurysm in a newborn

Congenital aneurysm of the ductus arteriosus is reported in 0.8% in neonatal autopsies; however, true incidence is unknown because of high rate of asymptomatic cases and spontaneous regression. Possible complications in symptomatic cases are thromboembolism, spontaneous rupture, erosion, infection, compression of airways, and death. In this report, we present a newborn with giant ductus arteriosus aneurysm (DAA) diagnosed in first day of life, surgically treated after thrombosis of aneurysm.

Antenatal occlusion of a ductal arteriosus aneurysm: a potential postnatal surgical emergency. Case report and literature review

Symptomatic presentation of ductal arteriosus aneurysm is usually a consequence of associated complications, including thromboembolism, infection, and compression of adjacent structures. In this case report, we present a thrombosed ductal aneurysm that developed antenatally with further postnatal progression of the thrombus and complete occlusion of the left pulmonary artery. Urgent surgical thrombectomy was successful and the post-operative course was uneventful.

Pulmonary Stenosis Caused by Ductus Arteriosus Aneurysm: A Case Report

A 76-year-old woman with a 2-week history of dyspnea on exertion was admitted to our hospital. A computed tomography scan showed a 70-mm diameter aortic arch aneurysm containing a large thrombus that was compressing the pulmonary artery. Echocardiography showed severe pulmonary stenosis and no shunt flow. Operative findings revealed an aneurysmal thrombus protruding into the lumen of the pulmonary artery through a foramen. A ductus arteriosus aneurysm was diagnosed. After the thrombus removal, arch replacement and ductus closure with a prosthetic patch were performed. Histological examination showed that the thrombus had no vascular components. The patient’s symptoms were relieved, and she was discharged.

Congenital ductus arteriosus aneurysm: an unusual cause of transient neonatal hypertension

Case 1: A term male child was re-admitted on day 10 of life due to acute onset of respiratory distress. Physical examination revealed tachypnoea, tachycardia and blood pressure (BP) above the 95th centile in all four limbs. Cardiovascular examination revealed a short systolic murmur on the sternal border. Abdomen showed hepatomegaly of 3 cm below the costal margin. Chest X-ray showed a cardiothoracic ratio of 0.65 with normal vascularity. Ultrasound and Doppler of the kidneys and brain were normal. The high parasternal view showed a large ductus arteriosus aneurysm (DAA) of 2.0 × 2.5 cm. The baby was managed with inotropes and antihypertensives. CT angiogram showed 1.6 × 0.6 cm thrombosed DAA, which was extending from the posterior descending aorta to the ampulla. With the resolution of aneurysm BPs normalised and antihypertensives were stopped at 6 weeks of age. Case 2: A premature male neonate weighing 1.2 kg was admitted to the neonatal intensive care unit for respiratory distress syndrome. On the 4th day of life during routine measurement of vitals, the BP was consistently above 95th centile in all four limbs. Blood tests revealed thrombocytopenia that persisted inspite of single donor transfusions. The evaluation for sepsis was negative. The ultrasound and Dopplers of the kidneys and brain were all normal. A transthoracic echocardiogram showed a large DAA measuring 5 × 1.8 mm. Hypertension was managed with antihypertensives. Serial transthoracic echocardiogram showed organising DAA. CT angiogram showed 6 mm × 2 mm thrombosed DAA. As the arterial BP normalised, antihypertensives were stopped on day 15 of life. The baby was discharged on day 29 of life and on follow-up BP remained normal.