Ductus Arteriosus Aneurysm and Vocal Cord Paralysis

A 3-day-old full-term infant was transferred to our pediatric intensive care unit because of significant biphasic stridor with desaturation spells. The history revealed an uncomplicated pregnancy and normal spontaneous vaginal delivery. The mother was known to have hypothyroidism caused by Hashimoto thyroiditis (negative thyroid-stimulating immunoglobulin). Apgar scores were 6 and 9 after 1 and 5 minutes; no resuscitation was needed. Umbilical arterial and venous blood gas values showed marked acidosis (pH 6.81 and 6.88, respectively) without signs of encephalopathy. General and cardiovascular examinations were normal. In particular, there was no marfanoid habitus, heart sounds were normal, and peripheral pulses were preserved. Chest x-ray illustrated a pronounced cardiac silhouette …