Incidental detection of a giant ductus arteriosus aneurysm by low-dose multidetector computed tomography in an asymptomatic adult Gianluca Pontone, MD,

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Incidental detection of a giant ductus arteriosus aneurysm by low-dose multidetector computed tomography in an asymptomatic adult Gianluca Pontone, MD, Daniele Andreini, MD, Antonio L. Bartorelli, MD, Luca Dainese, MD, Melissa Fusari, MD, Paolo Biglioli, MD Journal of Vascular Surgery Volume 51, Issue 5, Pages 1260-1264 (May 2010) DOI: 10.1016/j.jvs.2009.11.051 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Chest radiograph shows a smooth rounded mass in the aortopulmonary window (arrow) in the anteroposterior projection (A) and thin parietal calcifications at the periphery of the lesion (arrows) in the lateral projection (B). Volume rendering MDCT reconstruction (C) and axial image (D) show a very large ductus arteriosus aneurysm (DAA) located in the minor curvature of the aortic arch (Ao) and directed toward the left pulmonary artery (PA). Several calcifications on the lateral wall of the aneurysm are visible (arrows). The contrast-filled lumen of the lesion shows an intermediate level of enhancement between that demonstrated by the aorta and pulmonary artery, suggesting a shunt between left and right circulation. LIMA, Left internal mammary artery. Journal of Vascular Surgery 2010 51, 1260-1264DOI: (10.1016/j.jvs.2009.11.051) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 MDCT multiplanar reconstruction showing the ductus arteriosus aneurysm (DAA) and the two patent pedicles linking the lesion with the aorta (black arrow) and pulmonary artery (white arrow) (A). En-face views of the pedicles linking the DAA with the pulmonary artery (arrow) (B) and aortic arch (arrow) (C). Multiplanar reconstruction of the LAD (D), LCX (E), and RCA (F) rules out the presence of significant coronary artery disease. Ao, Aorta; LAD, Left anterior descending coronary artery; LCX, Left circumflex coronary artery; PA, Pulmonary artery; RCA, Right coronary artery. Journal of Vascular Surgery 2010 51, 1260-1264DOI: (10.1016/j.jvs.2009.11.051) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Parasternal short axis echocardiographic view showing a large cavity causing moderate compression of the left pulmonary artery (*) (A). Color Doppler mapping demonstrates two shunt jets from the aorta to the aneurysm (red arrow) and from the aneurysm to the left pulmonary artery (white arrow) (B). Aortography in the anteroposterior projection with 20° of caudal angulation shows only a minimal outpouching of contrast in the area of the aneurysm (C). At selective angiography (60° left anterior oblique view, 25°cranial angulation) the aneurysm is seen (D). Ao, Aorta; DAA, Ductus arteriosus aneurysm; PA, Pulmonary artery. Journal of Vascular Surgery 2010 51, 1260-1264DOI: (10.1016/j.jvs.2009.11.051) Copyright © 2010 Society for Vascular Surgery Terms and Conditions