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CLINICAL STUDY: PEDIATRIC CARDIOLOGY

Isolated neonatal ductus arteriosus aneurysm

Sheng-Ling Jan, MD^*,*, Betau Hwang, MD, FACC, Yun-Ching Fu, MD^*, Jyh-Wen Chai, MD and Ching-Shiang Chi, MD^*

^* Division of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
Department of Radiology, Taichung Veterans General Hospital, Taichung, and National Yang-Ming University, Taipei, Taiwan
Division of Pediatric Cardiology, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan

Manuscript received March 20, 2001; revised manuscript received September 4, 2001, accepted October 23, 2001.

^* Reprint requests and correspondence: Dr. Sheng-Ling Jan, Taichung Veterans General Hospital, Division of Pediatric Cardiology, 160, Section 3, Chung-kang Road, 40705 Taichung, Taiwan.
sljan{at}vghtc.vghtc.gov.tw

OBJECTIVES: 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.

Abbreviations and Acronyms   AGA   appropriate for gestational age   BBW   birth body weight   DAA   ductus arteriosus aneurysm   GDM   gestational diabetes mellitus   LGA   large for gestational age   MRA   magnetic resonance angiography   PDA   patent ductus arteriosus

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