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. 1983 Feb;197(2):139–146. doi: 10.1097/00000658-198302000-00004

Surgical management of vascular ring.

M Roesler, M De Leval, A Chrispin, J Stark
PMCID: PMC1353101  PMID: 6824368

Abstract

Between 1968 and 1980, 51 children had an operation for various forms of vascular ring. Additional cardiac malformations were present in five patients, and six had noncardiac congenital anomalies. Although symptoms started within the first month of life in 39 infants, only 16 came to operation under three months of age, and a delay of more than six months occurred in 15. Stridor, often life-threatening, and recurrent infections were the most common symptoms, but dysphagia was also important. The reasons for delay in diagnosis are discussed. Barium swallow provided the diagnosis in 44 patients and suggested it in a further four patients. Innominate artery compression of the trachea was not diagnosed by barium swallow. Operations of various types were performed. Accuracy in diagnosis is important because not all patients could be treated through the classic left thoracotomy. Severe tracheomalacia was responsible for the only two deaths in the series; one of these had tracheostomy performed in the referring hospital, the second child also had Fallot's tetralogy. The large majority of the patients have done well, 76% being asymptomatic at follow-up. Minimal to moderate stridor persists among the remainder to the present time.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arciniegas E., Hakimi M., Hertzler J. H., Farooki Z. Q., Green E. W. Surgical management of congenital vascular rings. J Thorac Cardiovasc Surg. 1979 May;77(5):721–727. [PubMed] [Google Scholar]
  2. Berman W., Jr, Yabek S. M., Dillon T., Neal J. F., Akl B., Burstein J. Vascular ring due to left aortic arch and right descending aorta. Circulation. 1981 Feb;63(2):458–460. doi: 10.1161/01.cir.63.2.458. [DOI] [PubMed] [Google Scholar]
  3. Binet J. P., Longlois J. Aortic arch anomalies in children and infants. J Thorac Cardiovasc Surg. 1977 Feb;73(2):248–252. [PubMed] [Google Scholar]
  4. Castaneda A. R. Pulmonary artery sling. Ann Thorac Surg. 1979 Sep;28(3):210–211. doi: 10.1016/s0003-4975(10)63107-4. [DOI] [PubMed] [Google Scholar]
  5. Deanfield J. E., Chrispin A. R. The investigation of chest disease in children by high kilovoltage filtered beam radiography. Br J Radiol. 1981 Oct;54(646):856–860. doi: 10.1259/0007-1285-54-646-856. [DOI] [PubMed] [Google Scholar]
  6. Dunn J. M., Gordon I., Chrispin A. R., de Leval M. R., Stark J. Early and late results of surgical correction of pulmonary artery sling. Ann Thorac Surg. 1979 Sep;28(3):230–238. doi: 10.1016/s0003-4975(10)63111-6. [DOI] [PubMed] [Google Scholar]
  7. FEARON B., SHORTREED R. TRACHEOBRONCHIAL COMPRESSION BY CONGENITAL CARDIOVASCULAR ANOMALIES IN CHILDREN. SYNDROME OF APNEA. Ann Otol Rhinol Laryngol. 1963 Dec;72:949–969. doi: 10.1177/000348946307200409. [DOI] [PubMed] [Google Scholar]
  8. Fleming W. H., Umstott C. E., Symbas P. N., Mansour K. A., Hatcher C. R. The embryology and management of vascular rings. South Med J. 1976 Jul;69(7):878–880. doi: 10.1097/00007611-197607000-00021. [DOI] [PubMed] [Google Scholar]
  9. Godtfredsen J., Wennevold A., Efsen F., Lauridsen P. Natural history of vascular ring with clinical manifestations. A follow-up study of eleven unoperated cases. Scand J Thorac Cardiovasc Surg. 1977;11(1):75–77. doi: 10.3109/14017437709167818. [DOI] [PubMed] [Google Scholar]
  10. Gumbiner C. H., Mullins C. E., McNamara D. G. Pulmonary artery sling. Am J Cardiol. 1980 Feb;45(2):311–315. doi: 10.1016/0002-9149(80)90651-7. [DOI] [PubMed] [Google Scholar]
  11. Lincoln J. C., Deverall P. B., Stark J., Aberdeen E., Waterston D. J. Vascular anomalies compressing the oesophagus and trachea. Thorax. 1969 May;24(3):295–306. doi: 10.1136/thx.24.3.295. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. MUSTARD W. T., TRIMBLE A. W., TRUSLER G. A. Mediastinal vascular anomalies causing tracheal and esophageal compression and obstruction in childhood. Can Med Assoc J. 1962 Dec 22;87:1301–1305. [PMC free article] [PubMed] [Google Scholar]
  13. Nikaido H., Riker W. L., Idriss F. S. Surgical management of "vascular rings". Arch Surg. 1972 Aug;105(2):327–333. doi: 10.1001/archsurg.1972.04180080173029. [DOI] [PubMed] [Google Scholar]
  14. Park S. C., Siewers R. D., Neches W. H., Lenox C. C., Zuberbuhler J. R. Left aortic arch with right descending aorta and right ligamentum arteriosum. A rare form of vascular ring. J Thorac Cardiovasc Surg. 1976 May;71(5):779–784. [PubMed] [Google Scholar]
  15. Sade R. M., Rosenthal A., Fellows K., Castaneda A. R. Pulmonary artery sling. J Thorac Cardiovasc Surg. 1975 Mar;69(3):333–346. [PubMed] [Google Scholar]
  16. Tucker B. L., Meyer B. W., Lindesmith G. G., Stiles Q. R., Jones J. C. Congenital aortic vascular ring. Arch Surg. 1969 Oct;99(4):521–523. doi: 10.1001/archsurg.1969.01340160101023. [DOI] [PubMed] [Google Scholar]

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