Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-26T15:32:20.833Z Has data issue: false hasContentIssue false
  • English
  • Français

Aneurysms of the fetal arterial duct are usually benign

Published online by Cambridge University Press:  22 June 2022

Katherine Dalldorf ,
Kenan W. D. Stern Open the ORCID record for Kenan W. D. Stern [Opens in a new window]  and
David Ezon Open the ORCID record for David Ezon [Opens in a new window]
Katherine Dalldorf
Affiliation:
Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
Kenan W. D. Stern
Affiliation:
Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
David Ezon*
Affiliation:
Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
*
Author for correspondence: Dr D. Ezon, MD, Icahn School of Medicine, Mount Sinai Hospital, 1 Gustave Levy Place, Annenberg, 3rd Floor, New York, NY 10029, USA. Tel: +844 733 7692. E-mail: david.ezon@mssm.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Fetal arterial duct aneurysm, saccular, or fusiform enlargement of the arterial duct affect > 8% of pregnancies. It is uncommonly associated with serious sequelae postnatally, including thromboembolic events such as stroke and left pulmonary artery obstruction, rupture with demise, and vocal cord compression. Risk factors include maternal diabetes, late maternal age, maternal blood type A, large size for gestational age, and connective tissue disorders. The clinical importance remains unknown, making it difficult to determine how to monitor this finding postnatally.

Methods:

This is a retrospective echocardiogram study assessing the outcomes of fetally diagnosed arterial duct aneurysm. Images and records were reviewed to confirm the diagnosis and assess risk factors and outcomes. Descriptive statistics were performed.

Results:

Fifty-three affected fetuses were identified. The median gestational age at diagnosis was 34.9 weeks (IQR 32.6, 36.6). The median maternal age was 31 years (IQR 27.3–34.1). Eight (15%) had maternal diabetes. The most common blood type was type O. The median maximal dimension of the aneurysm was 7.6 mm (IQR 6.1, 8.7). The aortic end was the maximal dimension in 67.9%. Median postnatal follow-up period was 76 days (IQR 7.5, 368). No patients sustained postnatal demise related to the duct, rupture of the ductal aneurysm, cerebral infarction, or other sequelae. No newborn had associated connective tissue disorders. No patients underwent ductal intervention.

Conclusion:

In our experience, no adverse outcomes related to the ductal aneurysm were identified. This should be considered when counselling families about the need for postnatal follow-up.

Keywords

Fetal echocardiographyductal aortic aneurysmneonatology
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 6 , June 2023 , pp. 933 - 938
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tseng, JJ, Jan, SL. Fetal echocardiographic diagnosis of isolated ductus arteriosus aneurysm: a longitudinal study from 32 weeks of gestation to term. Ultrasound Obstet Gynecol 2005; 26: 50–56.CrossRefGoogle ScholarPubMed
Jan, S-L, Hwang, B, Fu, Y-C, Chai, J-W, Chi, C-S. Isolated neonatal ductus arteriosus aneurysm. JAC 2002; 39: 342–347.Google ScholarPubMed
Aly, SA, Contreras, J, Honjo, O, Villemain, O. Antenatal occlusion of a ductal arteriosus aneurysm: a potential postnatal surgical emergency. Case report and literature review. CTY 2020; 30: 1750–1752.CrossRefGoogle ScholarPubMed
Dyamenahalli, U, Smallhorn, JF, Geva, T, et al. Isolated ductus arteriosus aneurysm in the fetus and infant: a multi-institutional experience. JAC 2000; 36: 262–269.Google ScholarPubMed
Mielke, G, Benda, N. Reference ranges for two-dimensional echocardiographic examination of the fetal ductus arteriosus. Ultrasound Obstet Gynecol 2000; 15: 219–225.CrossRefGoogle ScholarPubMed
Siddiqui, S, Polanco, A, DiLorenzo, MP, et al. Massive ductal aneurysm in an asymptomatic child with Loeys-Dietz syndrome. Ann Pediatr Cardiol 2021; 14: 113–115.Google Scholar
Je, B-K, Yoo, S-Y, Lee, W, Kim, WS, Kim, I-O. Aneurysm of the ductus arteriosus in a patient with Larsen syndrome. Pediatr Radiol 2006; 36: 1215–1218.CrossRefGoogle Scholar
Ardhanari, M, Swaminathan, S. Congenital ductus arteriosus aneurysm in association with MYH11 mutation: a case report. CTY 2020; 30: 123–125.CrossRefGoogle ScholarPubMed
van den Berg, G, Helbing, WA, van Beynum, I, Krasemann, TB. Development of a ductal aneurysm in a patient with Williams syndrome, and subsequent interventional closure. Pediatr Cardiol 2020; 41: 213–214.CrossRefGoogle Scholar
Kirks, DR, McCook, TA, Serwer, GA, Oldham, HN. Aneurysm of the ductus arteriosus in the neonate. Am J Roentgenol 1980; 134: 573–576.CrossRefGoogle ScholarPubMed
Weichert, J, Hartge, DR, Axt-Fliedner, R. The fetal ductus arteriosus and its abnormalities – a review. Congenit Heart Dis 2010; 5: 398–408.CrossRefGoogle ScholarPubMed
Chodhary, M, Tomar, M, Radhakrishnan, S. Ductal aneurysm masquerading as non-resolving pneumonia: a challenging differential! Ann Pediatr Cardiol 2010; 3: 80–82.Google Scholar
Sheridan, RM, Michelfelder, EC, Choe, KA, et al. Ductus arteriosus aneurysm with massive thrombosis of pulmonary artery and fetal hydrops. Pediatr Dev Pathol 2012; 15: 79–85.CrossRefGoogle ScholarPubMed
Oh, SJ, Jeung, IC. A case of isolated congenital ductus arteriosus aneurysm detected by fetal echocardiography at 38 weeks of gestation. J Clin Ultrasound 2011; 39: 530–533.CrossRefGoogle ScholarPubMed
Jackson, CM, Sandor, GGS, Lim, K, Duncan, WJ, Potts, JE. Diagnosis of fetal ductus arteriosus aneurysm: importance of the three-vessel view. Ultrasound Obstet Gynecol 2005; 26: 57–62.CrossRefGoogle ScholarPubMed
Xu, E, Delpey, JG, Finel, E, Pennanéach, A. Ductus arteriosus aneurysm: case report and review of the literature. Arch Pediatr 2018; 25: 283–285.CrossRefGoogle ScholarPubMed
Masood, SA, Bokowski, JW, Kazmouz, S, Amin, Z. Ductus arteriosus aneurysm with organized thrombus in a neonate: echocardiograms from diagnosis to resolution. Tex Heart Inst J 2015; 42: 298–299.CrossRefGoogle Scholar
Lund, JT, Jensen, MB, Hjelms, E. Aneurysm of the ductus arteriosus. A review of the literature and the surgical implications. Eur J Cardio-Thorac Surg 1991; 5: 566–570.CrossRefGoogle ScholarPubMed
Brock, J, Nussbaum, E, Shows, J, Nguyen, S, Setty, SP. An unusual cardiac cause of unilateral neonatal wheezing. Case Rep Pediatr 2019; 2019: 9638518.Google ScholarPubMed
Hayashi, T, Yoshizawa, H, Yoshikawa, Y. A ductal aneurysm rapidly developing into coarctation of the aorta. Eur J Cardio-Thorac Surg 2013; 43: 1264.CrossRefGoogle ScholarPubMed
Fripp, RR, Whitman, V, Waldhausen, JA, Boal, DK. Ductus arteriosus aneurysm presenting as pulmonary artery obstruction: diagnosis and management. JAC 1985; 6: 234–236.Google ScholarPubMed
Manuel, DA, Kumar, P, Jose, J. Incidentally detected large neonatal ductus arteriosus aneurysm. Asian Cardiovasc Thorac Ann 2016; 24: 900–901.CrossRefGoogle ScholarPubMed
Psathas, ED, Katsargyris, A, Lioudaki, S, Moris, DN, Doulaptsis, M, Klonaris, C. Treatment paradigms for ductus arteriosus aneurysms in adults. Vascular 2014; 22: 297–301.CrossRefGoogle ScholarPubMed
Balanescu, SM, Linte, AL, Dregoesc, IM, Marc, MC, Iancu, AC. Endovascular treatment of an aortic aneurysm and patent ductus arteriosus. Anatol J Cardiol 2018; 20: 130–131.Google ScholarPubMed
Morgan, GJ, Yim, DLS, Hayes, AM, Martin, RP, Hamilton, MCK, Stuart, G. Imaging and percutaneous occlusion of a large aneurysm of the ductus arteriosus in an infant with Loeys-Dietz syndrome. Congenit Heart Dis 2013; 8: E192–E195.CrossRefGoogle Scholar

Dalldorf et al. supplementary material

Dalldorf et al. supplementary material 1

Download Dalldorf et al. supplementary material(Video)
Video 300.5 KB

Dalldorf et al. supplementary material

Dalldorf et al. supplementary material 2

Download Dalldorf et al. supplementary material(Video)
Video 796.2 KB

Dalldorf et al. supplementary material

Dalldorf et al. supplementary material 3

Download Dalldorf et al. supplementary material(Video)
Video 620.1 KB