Diagnosis and management of symptomatic congenital ductus arteriosus aneurysm in neonates

  • Dr Nageswara Koneti, CARE Hospital, The Institute of Medical Sciences, India
  • Dr Vasudevan Kanchi, CARE Hospital, The Institute of Medical Sciences, India
  • Dr Pramod Reddy, Fernandez Hospital, Hyderabad, India
  • Objective & Method: We report four neonates presented with stridor and diagnosed as Ductus Arteriosus Aneurysm (DAA) and managed successfully. All four neonates presented within 24 hours with stridor, respiratory distress and weak cry. Cardiovascular system examination revealed no abnormality. There was prominent ductus shadow in the chest skiagram in two neonates. The echocardiogram revealed a large DAA with tortuous patent ductus arteriosus. The suprasternal and high parasternal views showed triple star sign and rabbit ear appearance. All babies were closely observed and assessed by echocardiogram. Two babies underwent CT scan in view of significant obstructive symptoms to decide further management. Results: One neonate underwent surgical intervention as DAA was compressing the left bronchus. There was significant thrombus formation in the aneurysm observed in the remaining three neonates who were followed till the disappearance of DAA. All babies are doing well during the follow up. Conclusion: Ductus arteriosus aneurysm is an important cause for the stridor in neonates. Majority of the babies improve without any cardiac intervention however surgery may be needed if obstructive symptoms persist.

    Serial no. Sex Gestational age Risk factors Birth weight(kgs) Saturation(%) Ventilation Management
    Case1 M Term Nil 2.8 78 Yes Operated
    Case2 F 36 weeks Nil 2.1 92 No Conservative
    Case3 F Term Gestational Diabetes 3.5 60 Yes Conservative
    Case4 M Term Nil 2.7 95 No Conservative