Congenital aneurysm of the ductus arteriosus in neonates; should we be afraid?

Although isolated ductus arteriosus aneurysm has been reported as 0.8% in autopsy series, it has recently been reported as up to 8.8% with increased awareness. Most cases are asymptomatic and regress spontaneously. In this study, we aimed to evaluate the characteristics, clinical manifestations, and outcomes of ductus arteriosus aneurysm in neonates.

A total of 22 newborns with echocardiographic images recorded in the hospital registry system were identified to have a ductus arteriosus aneurysm. The demographic, clinical, and echocardiographic findings of the patients were extracted from the hospital records.

The mean gestational age and weight at birth of the newborns were 38 ^6/7 weeks (35 ^3/7 - 40 ^6/7 weeks) and 3203 g (2445-4080 g), respectively. The maximal length and width of the aneurysm ranged from 6 to 21 mm and 5.3 to 13 mm, respectively. In three of the patients, thrombus in the aneurysm was detected on the third day of life, leading to surgical excision of thrombus and ligation of the aneurysm in two. In the remaining 19 patients, the aneurysm regressed spontaneously and closed in an average of 5.3 days.

With increased awareness and earlier and more frequent application of echocardiography in newborns, the diagnosis of ductus arteriosus aneurysm is being reported more frequently. The most common scenario is spontaneous regression, however, it should not be forgotten that it can lead to serious complications, as reported previously. In selected cases, surgical treatment may be an option to prevent more serious or late complications, though the indications for surgical intervention remain unclear.