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

      Affiliations

    • 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

      Affiliations

    • 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

      Affiliations

    • Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
    • ,
  • Ming-Chih Lin, MD

      Affiliations

    • Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
    • ,
  • Chi-Lin Ho, MD

      Affiliations

    • Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
    • ,
  • Betau Hwang, MD

      Affiliations

    • Department of Pediatrics and Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China

Article Outline

 

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.

Neonatal echocardiographic screening in our series shows that the incidence of ductus arteriosus aneurysm is up to 8.8%, which is not as rare as we had thought.1 Most aneurysms (70.2%) become progressively smaller after ductal closure. Some aneurysms (29.8%) have progressive formation of thrombi. All aneurysms are undetectable by echocardiography 1 month later. The reported case is the biggest aneurysm in our series. MDCT demonstrates the benign natural course of the ductus arteriosus aneurysm.1, 2, 3

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References 

  1. Jan SL, Hwang B, Fu YC, Chai JW, Chi CS. Isolated neonatal ductus arteriosus aneurysm. J Am Coll Cardiol. 2002;39:342–347
  2. Kaushik N, Cohen RA, Helton JG. 3-D CT angiographic demonstration of a neonatal ductus arteriosus aneurysm with development of ductal calcification: are the “ductus bump,” ductus arteriosus aneurysm, and ductal calcification related?. Pediatr Radiol. 2004;34:738–741
  3. Lee WJ, Chen SJ, Wu MH, Li YW. Regression of ductus arteriosus aneurysm in a neonate demonstrated by three-dimensional computed tomography. Int J Cardiol. 1999;68:231–234

PII: S0022-3476(08)00110-8

doi:10.1016/j.jpeds.2008.02.034

The Journal of Pediatrics
Volume 153, Issue 1 , Page 143, July 2008

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