Ductus arteriosus aneurysm
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Aneurysm of the ductus arteriosus is a rare entity in adults The ductus arteriosus is a short tubular connection between the left pulmonary artery and aorta. A remnant of the left sixth aortic arch, it normally undergoes physiologic closure soon after birth. In the few reports of aneurysms involving a patent ductus arteriosus in adults, it is uncertain whether the ductus arteriosus recanalized or original patency persisted. Normal closure proceeds from the pulmonary artery to the aortic end. Therefore, when closure is incomplete, the pulmonary side closes and the aortic side remains patent. 60% fatality rate due to complications rupture (i.e. dissection, infection, and distal embolization occur) Criteria for resection include lesions greater than 3 cm in diameter, symptomatic aneurysms, and any that show progressive enlargement.
Diagnosis
Chest X-ray
- Ductus arteriosus aneurysm maybe perceived as a change in the contour of the aortic arch or aortopulmonary window (adenopathy, neoplasms,or aneurysms related to the aorta itself are certainly more common masses at this site).
- Calcifications at the periphery of the lesion suggesting its vascular nature.
CT
- CT will show the relationship of the aneurysm to the aortic arch and pulmonary artery, while possibly revealing calcifications not detected by plain radiographs.
- The diameter of the lesion and presence of mural thrombus also will be identified.
