Postoperative aneurysm of the ductus arteriosus: With fatal rupture of a mycotic aneurysm of a branch of the pulmonary artery

1. (1) The case of a 34-year-old woman with a large patent ductus is reported, with the unusual presenting symptom of hoarseness. Examination revealed no murmurs in the region of the ductus, the only auscultatory finding being that of pulmonary valve regurgitation. 2. (2) For technical reasons, only ligation of the ductus was carried out. Seven months later a large aneurysm of the ductus was discovered. One month later a mass appeared in the lower lobe of the right lung. One year postoperatively the patient died of a massive pulmonary hemorrhage. 3. (3) At autopsy the ligatures were found to have cut through and a large aneurysm had formed between the aorta and pulmonary artery at the site of the ductus. The fatal rupture however had not occurred at this site but was due to a mycotic aneurysm of the pulmonary arterybranch to the lower lobe of the right lung. 4. (4) This mycotic aneurysm had formed as a result of embolization of cotton and silk ligature material from the site of the ductus to a branch of the right pulmonary artery.