Spontaneous Regression of a Large Ductus Arteriosus Aneurysm in a Neonate

Tsai, I.-Chen; Fu, Yun-Ching; Jan, Sheng-Ling; Lin, Ming-Chih; Ho, Chi-Lin; Hwang, Betau

doi:10.1016/j.jpeds.2008.02.034

« Previous Next »The Journal of Pediatrics
Volume 153, Issue 1 , Page 143, July 2008

Spontaneous Regression of a Large Ductus Arteriosus Aneurysm in a Neonate

I.-Chen Tsai, MD
- Department of Pediatrics and Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China, Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
Yun-Ching Fu, MD, PhD
- Department of Pediatrics and Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China, Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
Sheng-Ling Jan, MD
- Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
Ming-Chih Lin, MD
- Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
Chi-Lin Ho, MD
- Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
Betau Hwang, MD
- Department of Pediatrics and Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China

Through screening echocardiography, a ductus arteriosus aneurysm was found in a 3-day-old male neonate with a gestational age of 40 weeks and a birth body weight of 3120 g. The pulmonary opening of the aneurysm was 0.21 cm. The multi-detector row computed tomography (MDCT) at the age of 5 days clearly delineated the large aneurysm with the maximal diameter of 1.5 cm, which was compressing the left pulmonary artery (Figure, A and 1C). Because he was asymptomatic and had no significant murmur, he was discharged without any treatment. Follow-up echocardiography at the age of 1 month showed that the pulmonary opening of ductus arteriosus was spontaneously closed. MDCT at the age of 9 months showed that the aneurysm was well thrombosed with rim calcification (Figure, 1B and 1D). The left pulmonary artery became bigger, without significant obstruction. The patient thrived without any symptoms.

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Figure.
Volume-rendering images of MDCT show A, a large ductus arteriosus aneurysm in a neonate at the age of 5 days and B, thrombosed aneurysm with rim calcification (arrowheads) at the age of 9 months. Oblique sagittal images show C, the aneurysm filled with contrast medium and compressing the left pulmonary artery at the age of 5 days. D, The left pulmonary artery became bigger and the organized thrombus was identified as the low-attenuation area within the calcified rim (arrowheads) at the age of 9 months. AAO, Ascending aorta; DA, ductus aneurysm; DAO, descending aorta; LPA, left pulmonary artery; MPA, main pulmonary artery; RV, right ventricle.