Aneurysm of the Ductus Arteriosus: A Congenital Lesion

Ruben J. Acherman; Bijan Siassi; Winfield Wells; Murphy Goodwin; Gregory DeVore; Smeeta Sardesai; Pierre C. Wong; Mahmoud Ebrahimi; Gilma Pratti-Madrid; William Castillo; Rangasamy Ramanathan

doi:10.1055/s-2007-999298

American Journal of Perinatology, Table of Contents

Am J Perinatol 1998; 15(12): 653-659
DOI: 10.1055/s-2007-999298

ORIGINAL ARTICLE

Aneurysm of the Ductus Arteriosus: A Congenital Lesion

Ruben J. Acherman¹ ^, ² , Bijan Siassi¹ ^, ² , Winfield Wells² , Murphy Goodwin¹ , Gregory DeVore³ , Smeeta Sardesai¹ , Pierre C. Wong² , Mahmoud Ebrahimi¹ , Gilma Pratti-Madrid¹ , William Castillo¹ , Rangasamy Ramanathan¹ ^, ²

¹Divisions of Cardiology, Neonatology, Maternal-Fetal Medicine, Echocardiography Laboratory, and Department of Pediatrics, LAC & USC Medical Center, Women's and Children's Hospital, University of Southern California, Los Angeles, California
²Divisions of Cardiology and Cardiothoracic Surgery, Childrens Hospital Los Angeles, University of Southern California, Los Angeles, California
³Maternal-Fetal Medicine, Genetics Institute, Pasadena, California

Abstract

ABSTRACT

The objective of this study was to evaluate the clinical, radiological, and echocardiographic findings in 11 neonates with aneurysm of ductus arteriosus presented in our institutions between 1993 and 1996, and to postulate a new theory for the pathogenesis of this lesion. Medical records, radiographic studies, and echocardiograms were reviewed. All infants underwent follow-up echocardiograms every 2 to 3 days until the aneurysm spontaneously resolved or surgery was performed. The infants were predominantly term males; six had evidence of fetal distress, two were diagnosed prenatally by fetal echocardiogram, chest X ray evidenced mediastinal mass in six patients. The first echocardiogram showed structurally normal heart with an aneurysmal patent ductus arteriosus. In eight patients the aneurysm completely resolved by 5 to 10 days. One infant underwent surgical resection of the aneurysm after observation for 11 days with no change in size. Thrombosis of the aneurysm was noted in two patients; both underwent surgery. Increasing reports of ductal aneurysms in infants may reflect the availability of high-resolution echocardiography and more frequent use of echocardiography in the neonatal intensive care unit. Spontaneous resolution occurred in the majority of cases as in previous reports. We postulate that, at least in some cases, aneurysm of the ductus arteriosus is a congenital lesion that may represent poststenotic dilation of the ductus due to turbulent flow through a stenotic segment at its pulmonary artery end during fetal life. The presence of aneurysm of the ductus arteriosus should be excluded in selected cases of fetal distress, by fetal echocardiography.

Keywords

Aneurysm of the ductus arteriosus - ductus arteriosus - fetal cardiology - fetal echocardiography - congenital heart disease

Full Text