Antenatal occlusion of a ductal arteriosus aneurysm: a potential postnatal surgical emergency. Case report and literature review

Aly, Safwat; Contreras, Juan; Honjo, Osami; Villemain, Olivier

doi:10.1017/s1047951120002711

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…There have been eight cases of newborn-onset DAA complicated with pulmonary artery thromboses, including the present patient (►Table 1). [9][10][11][12][13] One prenatally diagnosed case resulted in stillbirth. 14 All eight diagnosed cases after birth survived without recurrence or complications.…”

Section: Discussionmentioning

confidence: 99%

Ductus Arteriosus Aneurysm and Pulmonary Artery Thromboses in a Protein S-Deficient Newborn

Shirozu

Ichiyama

Ishimura

et al. 2023

AJP Rep

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Ductus arteriosus aneurysm (DAA) asymptomatically occurs in newborn infants and resolves spontaneously. High-risk DAA with compression, rupture and thrombosis requires early surgical intervention. Newborn infants have the highest risk of thrombosis among pediatric patients, but the genetic predisposition is difficult to determine in infancy. We herein report a neonatal case of massive thromboses in DAA and pulmonary artery. Desaturation occurred in an active full-term infant two days after birth. Echocardiography and contrast-enhanced computed tomography indicated thrombotic occlusion of the DAA and pulmonary artery thrombus. Urgent thrombectomy and ductus resection were successfully performed. After six months of anticoagulant therapy, the dissociated low plasma activity levels of protein S from protein C suggested protein S deficiency. A genetic study of PROS1 identified a heterozygous variant of protein S K196E, a low-risk variant of thrombophilia in Japanese populations. There have been seven reported cases with neonatal-onset symptomatic thromboses of DAA involving the pulmonary artery. All survived without recurrence after surgical intervention in five and anticoagulant therapy alone in two. Two newborns had a heterozygous methylenetetrahydrofolate reductase variant, but information on thrombophilia was not available for any other cases. A genetic predisposition may raise the risk of DAA thrombosis, leading to rapid progression.

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Section: Discussionmentioning

confidence: 99%

Ductus Arteriosus Aneurysm and Pulmonary Artery Thromboses in a Protein S-Deficient Newborn

Shirozu

Ichiyama

Ishimura

et al. 2023

AJP Rep

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“…Although DAA is known to regress spontaneously following the closure of the ductus arteriosus in infants with asymptomatic ductal aneurysms, the asymptomatic patient would wait at least 4-6 weeks before considering surgical resection. Thrombus in the pulmonary arteries or aorta and thromboembolic events has been described in DAA [ 1 , 2 , 7 ]. The presence of spontaneous echocardiographic contrast in DAA is the risk for thrombus.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic congenital ductus arteriosus aneurysm in a newborn: Case by approach

Huynh,

Pham,

et al. 2023

Radiology Case Reports

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“…In our series, there was no restrictive DA, but a tortuous DA detected in the 2nd trimester developed into a DAA in the 3rd trimester. DAA can be associated with connective tissue disease [25] and can become complicated by prenatal thrombosis [26] or postnatal extension of the DA thrombus (whose formation is a physiologic event in order for the DA to close) to the adjacent pulmonary artery [27] or to the descending aorta [28]. Thus, an antenatal diagnosis of DAA ensures a proper follow up, with planned delivery in a specialized center where surgical treatment is available.…”

Section: Detecting Minor Chdmentioning

confidence: 99%

The Additional Role of the 3-Vessels and Trachea View in Screening for Congenital Heart Disease

et al. 2022

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Background and Objectives: Although frequent and associated with high mortality and morbidity rate, congenital heart disease (CHD) has a suboptimal prenatal detection rate, with significant variation according to the scanning protocol. The aim of this study was to evaluate the role of the 3-vessels and trachea view (3VT) in detecting CHD, with or without the use of Color Doppler, with an emphasis on major CHD. Materials and Methods: We performed a retrospective study on 1596 unselected pregnant patients presenting at 11–37 weeks of gestation for a routine anomaly scan. We selected all CHD cases, and we analyzed the performance of the 4-chamber (4C) and 3VT view in detecting CHD. Results: A total of 46 fetuses with CHD were identified, yielding a 2.86% overall incidence, and 0.87% for major CHD. Grayscale 4C detected 47.8% of all CHD, going up to 71.7% by adding grayscale 3VT, with no major CHD remaining undetected by combining grayscale 4C and 3VT. Conclusions: Grayscale 4C and 3VT views are effective in detecting major CHD, thus proving their utility even in a low resource setting.

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Antenatal occlusion of a ductal arteriosus aneurysm: a potential postnatal surgical emergency. Case report and literature review

Cited by 6 publications

References 11 publications

Ductus Arteriosus Aneurysm and Pulmonary Artery Thromboses in a Protein S-Deficient Newborn

Ductus Arteriosus Aneurysm and Pulmonary Artery Thromboses in a Protein S-Deficient Newborn

Asymptomatic congenital ductus arteriosus aneurysm in a newborn: Case by approach

The Additional Role of the 3-Vessels and Trachea View in Screening for Congenital Heart Disease

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