Adult-type
aneurysms in the arterial duct are rare, and their spontaneous prognosis is poor. We performed surgical treatment of an
aneurysm in the arterial duct in a 62-year-old male. The patient had had
hoarseness since November 2003, and was referred to our hospital in March 2004. Thoracic CT and aortography demonstrated a sacciform
aneurysm in the aorta in the distal arch region on the lesser curvature side. The patient was diagnosed as having an adult-type
aneurysm in the nonpatent arterial duct, and underwent surgical treatment in April 2004.
Thoracotomy in the fourth left intercostal space was performed up to the thoracic aorta, and a sacciform
aneurysm, measuring 35 mm x 32 mm, was detected in the arterial duct. The recurrent laryngeal nerve adhering to the front surface of the
aneurysm was overextended. Under partial
extracorporeal circulation, the
aneurysm was excised, and replaced by an
artificial blood vessel. The postoperative course was satisfactory, and the patient was discharged from the hospital 14 days after surgery. The surgical outcome was good, and the
hoarseness was improved. Taking possible complications into consideration, surgical treatment can be recommended in the early stage.