Prenatal sonographic diagnosis of a vitelline vein aneurysm

We report a case of vitelline vein aneurysm detected at 23 weeks of gestation. Few postnatal cases of vitelline vein aneurysm have been reported; however, due to their similar appearances most of them were considered initially as umbilical vein dilatations. The accurate prenatal diagnosis of vitelline vein aneurysm and early postnatal surgical treatment are crucial steps to prevent postnatal obliterative extension of thrombosis that might cause severe neonatal morbidity.

True brachial artery aneurysm in a child aged 2 years

Congenital brachial artery true aneurysms are exceedingly rare. Most are pseudoaneurysms secondary to trauma or infection. We report a boy aged 2 years who presented with painless, pulsatile swelling on the medial aspect of the right arm, 4 cm above the elbow joint that had been present since birth. Spiral CT angiography showed a fusiform aneurysm of the distal right brachial artery with a peripheral crescent-shaped thrombus. Distal arteries were normally opacified. There was no evidence of abnormal dilation or stenosis in any other artery. The aneurysm was surgically resected, with vascularisation re-established using a reversed great saphenous vein graft. His postoperative course was uneventful. Early surgery should be performed for moderately sized to large aneurysms that recently increased in size, exhibited luminal thrombus formation or caused neurovascular distal limb compromise. Early surgery could prevent complications such as a ruptured aneurysm, thromboembolism or limb ischaemia or loss.

Surveillance and Conservative Management of a Persistent Sciatic Artery Aneurysm

A persistent sciatic artery aneurysm is a rare congenital vascular anomaly. Surgical intervention is reserved for symptomatic cases. The authors report the case of a 72-year-old woman who presented with thromboembolic occlusion of an aneurysmal persistent sciatic artery. Although initially symptomatic, she was managed expectantly with the aid of serial duplex sonographic imaging. The persistent sciatic artery subsequently thrombosed as a result of hypotension secondary to a myocardial infarction. No surgical intervention was required. The current literature on this condition is reviewed.

Giant pulmonary artery aneurysm in a 6-year-old child

A 6-year-old female child was admitted with complaints of progressive dyspnea on exertion since last 3 years. She was saturating 100% on room air with stable vitals. On clinical examination, left precordial bulge was seen with prominent epigastric pulsations. Chest X-ray showed rightward shift of mediastinum and huge homogenous opacity occupying almost entire left lung field. On two-dimensional echocardiography, a large aneurysmal mass was seen occupying left hemithorax which was suspected to be arising from pulmonary artery but its exact site of origin could not be determined. A small patent ductus arteriosus (PDA) was also seen. PDA could be seen directly supplying the aneurysm (Fig. 1). CT angiography was done to confirm the diagnosis. It showed a huge aneurysmal sac measuring 12 cm × 8.9 cm × 14 cm, arising from left pulmonary artery (LPA) opposite to the site of insertion of PDA. Sac was occupying most of the left lung and pushing down the left diaphragm (Fig. 2). Cause of formation of such a huge aneurysm could not be found out. Surgery was performed and mouth of the sac was closed along with ligation of duct, repair of LPA and drainage of the sac. After surgery, lung expansion was good. Patient was discharged and she is doing well.

A case of isolated congenital ductus arteriosus aneurysm detected by fetal echocardiography at 38 weeks of gestation

A 30 year-old pregnant woman (G1P0) was diagnosed with fetal ductus arteriosus aneurysm (DAA) at 38 weeks of gestation. The three-vessel view of the heart and the sagittal view of the ductal arch showed a 12-mm fusiform dilatation of the ductus arteriosus. Turbulent flow was detected in it by color Doppler. DAA was confirmed by postnatal echocardiography within 24 hours after birth and it spontaneously closed in the neonatal period. Congenital DAA, usually developed in the third trimester, is potentially fatal due to the possible complications such as spontaneous rupture, dissection, and thromboembolism.

Persistent sciatic artery aneurysm associated with the development of angiosarcoma: a case report

Persistent sciatic artery (PSA) is a very rare, but clinically significant, congenital anomaly. PSA is known to undergo aneurysmal formation; however, there have been no previous reports of a soft-tissue sarcoma arising from a PSA. We describe a 79-year-old woman with a 10 year history of a slowly growing mass on her right buttock. Physical examination revealed a painful, firm, pulsatile mass with a maximum diameter of 13 cm. Computed tomography angiography revealed that the mass arose from the PSA. We successfully excised the mass lesion with no postoperative circulatory disturbances. The final pathological diagnosis was aneurysmal PSA that focally developed secondary angiosarcoma.

Das Klippel-Trenaunay Syndrom bei gleichzeitigem Vorliegen von Viszeralarterienaneurysmen

Das Klippel-Trenaunay Syndrom (KTS) ist eine kongenitale Angiodysplasie der venösen Gefäßstrombahn mit der Symptomtrias kutane vaskuläre Naevi, Hypertrophie einer Extremität sowie Varikose und venöse Malformation. Die Koinzidenz eines KTS mit arteriellen Malformationen im Sinne von Nierenarterienaneurysmen findet sich in der Literatur lediglich in zwei Beschreibungen. Wir berichten über einen 40-jährigen Patienten, bei dem, neben einem KTS Aneurysmen einer A. renalis, der A. lienalis, der A. mesenterica superior sowie einer A. und V. poplitea beobachtet wurden. Neben der Darstellung des diagnostischen und therapeutischen Verlaufs wird über die in der Literatur dargestellten klinischen Erfahrungen berichtet. Differentialdiagnostisch sind zwei weitere Syndrome, ebenfalls aus dem Formenkreis der Phakomatosen, abzugrenzen: das Servelle-Martorell-Syndrom und das Frederick Parkes Weber-Syndrom.

Achsenanomalien der Vena cava inferior mit paracavalem venösen Aneurysma und renalem Kollateralkreislauf

Venöse Aneurysmata der großen Gefäße stellen anatomische Raritäten dar. Die meisten bisher publizierten Malformationen des venösen Systems betreffen hauptsächlich die Vena cava inferior und treten in unterschiedlichen Formen auf. Aussackungen der infradiaphragmalen Vena cava inferior werden bei routinemäßig durchgeführten abdominellen Sonographien nur selten beobachtet und stellen dann häufig Zufallsbefunde dar. Berichte hierüber beschränken sich auf einzelne Kasuistiken und bereiten den Klinikern nicht selten diagnostische und therapeutische Schwierigkeiten. In der vorliegenden Arbeit wird eine asymptomatische, ausgeprägte venöse trunkuläre Missbildung der Vena cava inferior mit suprarenaler Abflussstörung beschrieben. Der hier vorgestellte Fall stellt einen bislang nicht beschriebenen Befund dar. Unter Berücksichtigung der gesamten Befundkonstellation entschlossen wir uns zu einer konservativen Behandlung des Patienten.

Treatment of an aneurysmal dilatation of the ductus arteriosus with indomethacin in a premature infant

A large ductus arteriosus aneurysm can lead to potentially serious and life-threatening complications. We report a case of aneurysmal dilatation of the ductus arteriosus in a premature infant that was successfully treated with indomethacin. Thus, surgical intervention with general anesthesia could be avoided.

Total anomalous pulmonary venous connection with a ductus arteriosus aneurysm in a neonate: report of a case

We performed successful emergency surgery on a 1-day-old infant to repair a total anomalous pulmonary venous connection (TAPVC) and a ductus arteriosus aneurysm (DAA) diagnosed by two-dimensional echocardiography. We anastomosed the common pulmonary venous chamber to the left atrium and ligated the pulmonary end of the DAA. Echocardiography and cardiac catheterization done 3 months later showed that the DAA had regressed. To the best of our knowledge, this is the first report describing the successful repair of a supracardiac TAPVC with a DAA.

Congenital extrahepatic portal vein aneurysm

Portal vein aneurysm is a rare clinical entity, with only 41 published cases in the English-language literature. Twenty-five of them were congenital. We present the case of a 50-year-old woman who was incidentally diagnosed with a congenital extrahepatic portal vein aneurysm during an investigation for dyspepsia. Ultrasonographic features are described with correlation of computed tomographic and magnetic resonance findings. Etiology, clinical significance, and management strategies for these lesions are discussed and a review of the literature regarding this entity is presented.

[Antenatal diagnosis and management of vein of Galen aneurysm: review illustrated by a case report]

Vein of Galen aneurysm is a rare vascular congenital malformation. We report an antenatal diagnosis with duplex Doppler at 26 weeks gestation. Magnetic resonance imaging was used before and after delivery in order to determine neurological prognosis. The neonatal prognosis is poor if fetal cardiac insufficiency or cerebral lesions are present antenatally. Premature delivery does not improve the neonatal outcome. When the aneurysm is not life threatening, embolization of the malformation is at best delayed five months after birth.

Echocardiographic Diagnosis of Congenital Membranous Ventricular Septal Aneurysm in the Dog and Cat

Membranous ventricular septal aneurysm was diagnosed by echocardiography in 17 dogs and three cats. The aneurysm appeared as a thin membrane protruding into the right ventricle from the margins of a congenital ventricular septal defect (VSD). The aneurysm was intact in nine dogs and two cats and perforated by a small VSD in eight dogs and one cat. Other congenital heart defects were present in seven dogs. In all animals, the aneurysm was an incidental finding observed during echocardiographic examination, and it did not appear to directly cause any cardiac dysfunction.

Prenatal sonographic diagnosis of congenital ductus arteriosus aneurysm: a case report

The objective of this report was to demonstrate prenatal sonographic features of congenital ductus arteriosus aneurysm (DAA), a rare, but possibly fatal abnormality. It is characterized by a saccular or fusiform dilatation of the ductus arteriosus. The majority of affected neonates are clinically asymptomatic and tend to progressively diminish in size of DAA and spontaneous closure. However, serious complications can occur during waiting periods, including spontaneous rupture or thromboembolism.

CASE

A 35 year-old Thai woman, G2P1, underwent ultrasound examination at 34 weeks' gestation. Fetal echocardiography revealed markedly enlarged and tortuous ductus arteriosus with saccular dilation at the distal end, just before joining the descending aorta. The cross-sectional diameter of the saccular portion of the ductus arteriosus was 10 mm. The active female baby was vaginally delivered at 34 weeks' gestation, weighing 1050 grams. Postnatal echocardiography confirmed the prenatal findings. The DAA was gradually decreased in size and finally spontaneously closed without medical or surgical intervention.

Congenital circumflex coronary arteriovenous fistula with aneurysmal termination in the pulmonary artery

Coronary arteriovenous fistula is a rare congenital anomaly that is seen in 0.1 % to 0.2% of coronary angiograms. Aneurysmal formation in the fistula is even rarer. We report a case of congenital circumflex arteriovenous fistula with aneurysmal formation just near its termination in the pulmonary artery, associated with atherosclerotic left anterior descending coronary artery. The anomaly was successfully repaired.

Congenital aneurysm of the muscular interventricular septum in a child

Congenital aneurysms of the muscular interventricular septum without ventricularseptal defect are extremely rare. We describe a five-month-old girl patient with congenital aneurysm, pathological ST changes and minimal right ventricular outflow tract obstruction. The electrocardiogram showed Wolf-Parkinson-White syndrome, pathological ST changes and combined ventricular hypertrophy criteria. The transthoracic echocardiography and cardiac catheterization demonstrated a septal aneurysm which was bulging into the right ventricle and systolic pressure gradients between the main pulmonary artery and right ventricle outflow tract with normal coronary arteries. The patient has shown no symptoms, but some rhythm disturbances may be expected because of her electrocardiographic anomalies. Therefore, these patients should be followed carefully because of possible complications.

A case of macrocephaly-cutis marmorata telangiectatica congenita and review of neuroradiologic features

Macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC) is characterized by macrocephaly, cutis marmorata, capillary malformations, toe syndactily, joint laxity and pre-natal overgrowth. Cerebral abnormalities might also be seen. We reported cerebral magnetic resonance imaging (MRI) findings of a case with M-CMTC, who had giant atrial septal aneurysm and atrial septal defect. Cerebral alterations determined by MRI were bilateral prominent lateral ventricles, bilateral cortical dysplasia, cavum septi pellucidum cyst and calvarial hemangioma. At 17th day of his life he suddenly developed cardiorespiratory arrest and died.

Congenital giant aneurysm of the left innominate vein: is surgical treatment required?

Congenital aneurysms of the thoracic venous system are rare. In particular, innominate venous aneurysms are extremely rare. We describe a 16-year-old girl whose chest x-ray suggested a mediastinal tumor. Three-dimensional contrast-enhancement magnetic resonance venography showed a giant sacciform aneurysm of the left innominate vein and dilatation of the right innominate vein. The patient was asymptomatic, and there were no significant physical findings. Therefore, the patient is being followed without surgical treatment.

Congenital internal and external jugular venous aneurysms in a child

A 2-year-old boy presented with varices and a neck mass. Imaging studies revealed internal jugular vein aneurysm. Gradual increasing of the mass, potential thrombus formation and cosmetical considerations were indications for surgery. At surgery aneurysms of both the external and internal jugular veins were found and resected.

Subclavian artery aneurysm in association with congenital absence of ipsilateral internal carotid artery

Aneurysms of the subclavian artery are rare. Similarly, congenital absence of the internal carotid artery is an extremely rare vascular anomaly. In this report, we discuss the case of a 54 year-old woman with an unusual aneurysm of the right subclavian artery in association with congenital absence of the right internal carotid artery. The aneurysm was successfully surgically repaired. On the basis of the appearance of the aneurysm and the absence of known atherosclerotic risk factors in this patient, it is hypothesized that the aneurysm is, in fact, congenital and related to anomalous development of the embryonic aortic arch branches.

Congenital right subclavian artery aneurysm: a case report

Aneurysms of the subclavian artery are unusual. The most common causes are atherosclerosis and trauma. We report one case of an elongated and tortuous right subclavian artery with an aneurysm involving the origin of the right vertebral artery. The patient underwent resection of the lesion with an end-to-end anastomosis of the subclavian artery and implantation of the right vertebral artery into the right common carotid artery. Results were consistent with a rare congenital subclavian aneurysm.

[Right atrial compressive aneurysm with favorable outcome after surgery at the age of 1 month]

Right atrial aneurysms are uncommon and often revealed by arrhythmia. We report a case of right atrial aneurysm which required an early management and its follow up during one year. The abnormality was detected at 32 weeks gravida during a systematic echography. At birth the newborn was asymptomatic but with the progressive increase of the aneurysm size shifting the heart and vessels and the occurrence of an intra-cardiac thrombus, a surgical management was decided at the age of one month. The resection of the aneurysm was therefore performed and no complication occurred during recovery. After one year the child remains healthy. The surgical indications are difficult to precise as the majority of these aneurysms are detected at an adult age. Surgical management appears to be essential in case of poor tolerance. The prognosis after surgery seems favorable.

Isolated neonatal ductus arteriosus aneurysm

OBJECTIVE

A prospective study was performed to evaluate the incidence, clinical manifestations and outcome of ductus arteriosus aneurysm (DAA) in full-term neonates.

BACKGROUND

Ductus arteriosus aneurysm has been considered to be a rare congenital lesion and a potentially fatal abnormality.

METHODS

A total of 548 full-term neonates received echocardiographic screening.

RESULTS

There were 48 (8.8%) patients (28 boys and 20 girls) with DAA detected by echocardiography. The maximal diameter of the DAA ranged from 6.5 to 11.2 mm (8.2 +/- 1.2 mm). All cases were asymptomatic. There were no significant differences in gender, gestational age, maternal age or Apgar score between the newborns with or without DAA. Newborns with DAA had a higher birth body weight, higher incidence of maternal gestational diabetes mellitus and more mothers with blood group A, compared with newborns without DAA (p < 0.05). Follow-up echocardiograms showed spontaneous closure of the ductus arteriosus in all patients except those without DAA. The DAA became progressively smaller after ductal closure in 33 patients (70.2%) and completely disappeared by 7 to 35 days of life. The other 14 patients (29.8%) with DAA had echocardiographic evidence of progressive formation of thrombi between the third and tenth day of life. The DAA and thrombi spontaneously disappeared in all patients by one month after birth.

CONCLUSIONS

There is a higher incidence of DAA with a good outcome in our series compared with previous reports. We speculate that the presence of DAA may be a normal variant of the ductal bump and part of a normal process of spontaneous ductal closure in full-term neonates.

Aneurysmal dilatation of the ductus arteriosus in a neonate

Fetal ultrasound provides the capacity for early detection of a variety of congenital heart diseases. We report a case of aneurysmal dilatation of a patent ductus arteriosus detected in utero and subsequently confirmed by transthoracic echocardiography in the neonatal period. Prompt recognition of the ductus aneurysm with resultant surgical ligation may have averted potentially serious complications from this condition.

Aneurysm of the ductus arteriosus in a neonate with 13q-deletion

Aneurysm of the ductus arteriosus is a rare abnormality for which different ways of pathogenesis are described. We report the case of a fatal thrombosis of an aneurysm of the ductus arteriosus in an infant presenting feeding difficulties and a mild dysmorphic facies. Karyotype analysis revealed a de novo chromosomal deletion 46,XY, del (13)(q12.3,q22.3). To the best of our knowledge, this is the first case of an aneurysm of the ductus arteriosus associated with a chromosomal aberration.

Congenital aneurysm of the left main coronary artery with fistulous communication to the right atrium and coronary 'steal' phenomenon

We describe a unique case of a left coronary arteriovenous fistula arising from an extremely short and aneurysmal left main coronary artery and selectively affecting the blood flow in the circumflex coronary artery. The relevant diagnostic contributions of two-dimensional echocardiography, colour flow Doppler, cardiolite stress testing and coronary angiography are discussed. The haemodynamic features of this anomaly are reviewed.

[Aneurysm of the ductus arteriosus Botalli]

A congenital aneurysm of the ductus arteriosus Botalli was detected by chest X-ray as an intrathoracic mass in a 7-day-old infant. Following confirmation of the diagnosis by echocardiography and MRI the aneurysm was successfully resected via left lateral thoracotomy without cardiopulmonary bypass. The postoperative course was uneventful. Six years after operation the patient is asymptomatic and growing normally. An intrathoracic mass may be considered in the differential diagnosis especially in infants and children. Aneurysms of ductus arteriosus potentially are associated with serious complications. Timely diagnosis and early surgical intervention are decisive for prevention of serious complication and death.

A case report of a patient with a large aneurysmatic coronary artery fistula

A coronary artery fistula is a rare congenital malformation, which can become symptomatic in adulthood. This report describes a 65-year-old patient with a large aneurysmatic fistula who presented with signs of heart failure. Angiographically a large aneurysmatic fistula was found running from the left coronary artery to the junction of the superior vena cava and the right atrium.

Right coronary artery to left ventricular fistula associated with left ventricular aneurysm

An infant with right coronary artery to left ventricular fistula associated with left ventricular aneurysm successfully underwent a division of fistula under cardiopulmonary bypass. Follow-up angiogram showed the patency of the right coronary artery, no recurrence of fistula, and the regression of the left ventricular aneurysm. Because the lesion may progress with age, early diagnosis and surgical intervention are indicated to prevent later complications.

Congenital aneurysm of the ulnar artery in the palm

An aneurysm of the palmar ulnar artery is rare and usually follows penetrating or blunt trauma to the hypothenar eminence. We report a case in which there was no history of trauma and the aneurysm may have been of congenital origin.

Spontaneous closure and thrombosis of a ductal aneurysm in a neonate

The natural history of a ductal aneurysm detected prenatally is presented. Neurologic concerns in the neonate and absence of cardio-respiratory compromise permitted serial echo demonstration of constriction, thickening and subsequent closure with formation of thrombus in the aneurysm.

[Congenital aneurysm of the trunk of the pulmonary artery]

A case of congenital aneurysm of the main pulmonary artery incidentally discovered following blunt chest trauma is reported. This anormaly is rare and the authors will emphasize the plain radiographic and MRI findings. The etiology and evolution of this entity are not well known.

Neonatal ductus arteriosus aneurysm causing nerve palsies and airway compression: surgical treatment by decompression without excision

A 4-kg male child, born at 34 weeks to a gestational diabetic mother, had a large ductus arteriosus aneurysm causing phrenic and recurrent laryngeal nerve palsies and large airway compression. The right and left atrial appendages and distal descending aorta were cannulated, allowing left heart partial or complete cardiopulmonary bypass as necessary. On bypass the ductus was ligated, decompressed, and oversewn but not excised. Examination 1 month later suggested resolution of the recurrent laryngeal palsy and echocardiography showed regression of the aneurysm. Ductus ligation and decompression was an effective surgical treatment, which is less likely to cause complications than resection.

A case of extrahepatic portal vein aneurysm with massive thrombosis: diagnosis with reconstruction images from helical CT scans

A patient with extrahepatic portal vein aneurysm with massive thrombosis, congenital in nature, is reported. Reconstructed images using curved reformation software and three-dimensional images from helical CT were useful to delineate the shape of the portal vein aneurysm and extension of the thrombi.