**Core Concept**
Congenital rubella syndrome (CRS) is a condition that occurs when a fetus is infected with the rubella virus, usually during the first trimester of pregnancy. This infection can lead to various congenital anomalies and complications.

**Why the Correct Answer is Right**
Congenital rubella syndrome is characterized by a range of clinical features, including deafness, cataracts, congenital heart disease, patent ductus arteriosus, and intellectual disability. The pathogenesis of CRS involves the direct effects of the virus on the developing fetus, as well as the indirect effects of maternal immune responses.

**Why Each Wrong Option is Incorrect**
**Option A:** Deafness is a common feature of CRS, often resulting from damage to the auditory system. It is not a feature that is not seen in CRS.
**Option B:** Patent ductus arteriosus is a type of congenital heart disease that is commonly associated with CRS. Therefore, it is not the correct answer.
**Option C:** Congenital heart disease, including patent ductus arteriosus, is a hallmark of CRS, making it an incorrect option.

**Clinical Pearl / High-Yield Fact**
CRS is often associated with a characteristic "blueberry muffin" appearance of the newborn's skin, due to the presence of extramedullary hematopoiesis.

**Correct Answer: D.**