Materiały źródłowe

• #1 Vascular Rings: Causes and Symptoms

  https://my.clevelandclinic.org/health/diseases/23947-vascular-rings

  A vascular ring is a congenital heart defect that can cause problems with breathing or eating. […] A vascular ring is a congenital defect, meaning it’s present at birth. The condition can be life-threatening, but surgery is usually successful. […] Vascular rings that are pressing on your trachea or esophagus require surgery. […] Surgery to correct a vascular ring is quite safe and often successful. Although you or your child may have symptoms for a few months afterward, most people are symptom-free within a year of surgery. […] A vascular ring is an abnormal formation of the aorta that presses on the trachea, esophagus or both. The congenital defect can cause problems with breathing or eating. If you or your child has a vascular ring, surgery can correct the condition and eliminate symptoms. […] Cleveland Clinic Childrens providers treat vascular rings in babies and children with compassionate support and excellent results.

• #2 Vascular Rings | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/vascular-rings/

  Vascular rings occur during fetal development due to an abnormal formation of the aorta (the artery that delivers oxygen to the body) and the surrounding blood vessels. These vessels form a ring around the trachea (brings air to the lungs) and the esophagus (brings food to the stomach). Vessels in the wrong position may cause pressure on these structures. […] Symptoms of a vascular ring can vary. Some children never develop symptoms. The more pressure the rings apply to the trachea and esophagus, the more severe the symptoms will be. […] Vascular rings must be surgically corrected. This can be done either through a left thoracotomy or a median sternotomy. If a left thoracotomy is used, you should expect a 2-day hospital stay. A median sternotomy requires cardiopulmonary bypass and therefore, has a longer recovery of 5-7 days.

• #3 Prenatal ultrasound scans showing a vascular ring | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/prenatal-ultrasound-scans-showing-vascular-ring/

  This information sheet from Great Ormond Street Hospital (GOSH) explains about vascular rings detected during a prenatal ultrasound scan and what this might mean for your child. […] When we carried out a prenatal ultrasound scan in the Fetal Cardiology clinic, we were able to confirm that your baby has a structurally normal heart but there is an unusual arrangement of the great arteries after they have left the heart called a vascular ring. This arrangement has the potential to form a ring round the trachea (windpipe) and oesophagus (food pipe). […] The baby may never have any symptoms or it might gradually give rise to breathing problems and/or swallowing problems if the vascular ring squashes the oesophagus and/or trachea. […] If the ring is tight enough to cause problems you may notice:

• #4 Vascular Rings – Seattle Children’s

  https://www.seattlechildrens.org/conditions/vascular-rings/

  Vascular rings are abnormal arteries around the trachea and esophagus. The arteries can press on the trachea and esophagus, causing problems with breathing and feeding. […] Most babies with vascular rings have symptoms because the rings put pressure on their trachea and esophagus. Some children have no symptoms as babies. They may develop symptoms as they get older. […] Some children with vascular rings need treatment, and some do not. Children who have symptoms need surgery. During surgery, your child’s surgeon cuts the rings so they do not press on the trachea or esophagus. […] Your child may need medicine to help with their symptoms until they can have surgery. […] If your child has vascular rings but no symptoms, your child’s doctor will want to check your child on a regular basis to see if any symptoms start to develop.

• #5 Vascular Ring | Norton Children’s

  https://nortonchildrens.com/services/cardiology/conditions/congenital-heart-disease/vascular-rings/

  A vascular ring happens when the aorta or its branches form a complete ring around the trachea (windpipe) and the esophagus, the tube that leads from the throat to the stomach. […] A vascular ring is a birth defect that can cause issues with breathing and eating. Children with a vascular ring may have symptoms as a baby or during early childhood. […] Most babies with a vascular ring will have symptoms caused by the pressure the rings put on their trachea and esophagus. Some children with a vascular ring have no symptoms as babies, but develop symptoms as they get older. […] Pressure on the trachea can cause breathing issues such as loud or labored breathing, wheezing or high-pitched cough, infections in the lungs or repeated pneumonia, and breathing issues that get worse when a baby tries to feed or when an older child eats.

• #6 Vascular Ring | Norton Children’s

  https://nortonchildrens.com/services/cardiology/conditions/congenital-heart-disease/vascular-rings/

  Pressure on the esophagus can cause issues such as acid reflux, choking, eating slowly, trouble swallowing, trouble eating solid food, and vomiting. […] If your child has vascular rings but doesn’t have symptoms, your doctor will want to see your child regularly to check whether any symptoms develop. […] Children who have symptoms from vascular rings will need surgery. The procedure is not open heart surgery but does involve surgery inside the chest. In many cases, the surgeon makes a small incision on the left side of the chest and goes between the ribs to make the repair. […] The surgeon will cut and stitch closed one of the arches, usually the left, so the aorta no longer encircles or puts pressure on the trachea or esophagus. […] The surgeon divides the ligamentum arteriosum so that it no longer puts pressure on the trachea or esophagus. The right aortic arch remains, as a person can live with this type of defect.

• #7 Vascular ring: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007318.htm

  Vascular ring is an abnormal formation of the aorta, the large artery that carries blood from the heart to the rest of the body. It is a congenital problem, which means it is present at birth. […] Surgery is usually performed as soon as possible on children with symptoms. The goal of surgery is to split the vascular ring and relieve pressure on the surrounding structures. The procedure is usually done through a small surgical cut in the left side of the chest between the ribs. […] Children who do not have symptoms may not need treatment but should be carefully monitored to make sure the condition does not become worse. […] Contact your provider if your baby has symptoms of vascular ring. Getting diagnosed and treated quickly can prevent serious complications.

• #8 Vascular Rings Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/426233-treatment

  Surgical division of a vascular ring is indicated in all symptomatic patients. To avoid serious complications such as sudden death or significant tracheal or bronchial damage, surgery should not be delayed, especially in patients with symptoms of airway compression. […] Individuals who have no symptoms from a vascular ring may not require surgical intervention. […] Surgical division of symptomatic vascular rings is the only appropriate form of therapy. Surgery should be performed promptly after the diagnosis is made, especially in patients with stridor, apnea, or other symptoms of respiratory distress. Delay in operative intervention can result in complications of a serious nature. […] Immediate postoperative management after division of a vascular ring is performed in an intensive care unit (ICU). The majority of patients can be extubated immediately or within a short time after the operation.

• #9 Influence of Fetal Diagnosis on Management of Vascular Rings – Congenital Heart International Professionals (CHiP) Network

  https://thechipnetwork.org/influence-of-fetal-diagnosis-on-management-of-vascular-rings/

  There has been an increasing frequency of fetal diagnosis of vascular rings. Increasing frequency of fetal diagnosis was noted in the past 10 years. Patients with a fetal diagnosis were significantly younger at the time of surgery and there were no differences in postoperative complications or length-of-stay for fetal diagnosis vs. postnatal diagnosis. Fetal diagnosis leads to the potential for expectant management of vascular ring patients and may lead to improved long-term outcomes. […] Authors recommendations for the management of a patient with a fetal diagnosis of vascular ring: Getting an echocardiogram at birth in all patients to evaluate for intracardiac pathology and confirm the fetal diagnosis. If the patient is asymptomatic, we recommend a CT scan at 2-4 months of age when general anesthesia is not required. Post-scan 3D reconstruction is then performed for an extremely precise depiction of the anatomic features of the vascular ring. Significant external tracheal compression is an indication for operative intervention even in an asymptomatic patient. If the patient has a double aortic arch we recommend operative intervention at 6-9 months of age even if they have minimal or no symptoms. In the postnatal diagnosis group symptoms began to appear at 6 months of age. For patients with a right aortic arch, if Kommerell diverticulum resection and left subclavian artery transfer are indicated, operation is recommended at 12-18 months of age. Left subclavian artery transfer is eminently feasible at this age with an anastomosis of a vessel 3.0-3.5 mm in diameter. The timely removal of the Kommerell diverticulum will prevent known late complications of aneurysm formation, and aortic dissection. For vascular ring patients who become symptomatic prior to 2-4 months of age we perform CT imaging followed by surgical repair at the time of symptom onset. In the special case of pulmonary artery sling we perform CT imaging prior to hospital discharge to rule out complete tracheal rings and tracheal stenosis. Median age at pulmonary artery sling repair was 3 months of age.

• #10 What Are Vascular Rings?

  https://www.icliniq.com/articles/heart-circulatory-health/vascular-rings

  Children who have vascular rings but do not exhibit any symptoms typically do not require surgery. […] On the other hand, patients with vascular ring symptoms usually need surgery to open their airways and esophagus. […] Postoperative hospital stays often last one or two days. Surgery to split a vascular ring carries a minimal risk. […] The majority of doctors will choose surgery over close observation of the patient. […] Vascular ring surgery aims to restore blood flow through the vessels. The symptoms will subside when the ring is opened in at least one way. […] After they are fixed, the patient often no longer has any symptoms. They do not require constant medical follow-up.

• #11 Vascular rings – what has changed, and what do I need to know as a practitioner? | Cardiology in the Young | Cambridge Core

  https://www.cambridge.org/core/journals/cardiology-in-the-young/article/vascular-rings-what-has-changed-and-what-do-i-need-to-know-as-a-practitioner/101C8D89EFAD9C234DD6B16851D497C1

  The clearest indication for surgical repair is symptoms with known anatomy consistent with a vascular ring. […] Recently, there has been a substantial increase in the frequency of diagnosis in asymptomatic patients and on fetal echocardiogram. […] The goal of surgery is alleviation of symptoms and prevention of permanent airway or oesophageal dysfunction, achieved through the relief of the compression. […] Outcomes after vascular ring repair are excellent with a low risk of complications or need for reintervention. […] Vascular ring repairs are performed with low complication rates. […] For those who do not experience symptomatic improvement, or have improvement with subsequent recurrent symptoms, repeating the diagnostic workup is necessary. […] Currently, the decision on when to offer surgical repair differs from institution to institution and even practitioner to practitioner. […] The diagnosis and treatment of vascular rings is undergoing a paradigm shift.

• #12 Vascular Ring Anomaly | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vascular-ring

  A vascular ring is a type of congenital (present at birth) defect. This happens when normal vessels are in the wrong place. This may cause pressure on the esophagus or airway. […] Surgery to divide the vascular ring is indicated in all symptomatic cases. […] The goal of surgery for vascular rings is to make sure blood can flow through the vessels freely. When the ring is open in at least one direction, symptoms will be relieved. […] In most cases the surgery is done using an small cut on the left side of the chest. This allows entry between the ribs. […] Hospitalization after surgery is usually a day or two. […] Complete relief of symptoms may show up right away after surgery. […] Improvement of swallowing symptoms in such cases may be seen gradually. […] Vascular rings do not often present in adult life. When they do, they are assessed and managed by surgeons. If they have been repaired, the patient usually becomes free of symptoms. They do not need ongoing follow up with a doctor.

• #13 Vascular Ring | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vascular-ring

  Vascular rings require surgery (not open heart) if there are symptoms. In most cases, the surgeon makes an incision on the left side of the chest and goes between the ribs to access the area. […] The procedure to correct vascular ring is considered low risk. In cases where there are symptoms as outlined above, surgery is recommended. […] In most cases, children with vascular rings recover completely after surgery and wont need additional procedures. It is not uncommon for noisy breathing to continue for several weeks or months after surgery as the trachea slowly takes on a more normal shape. Sometimes, symptoms such as coughing or labored breathing continue after surgery because the airway is soft (called malacia). We will monitor your child to make sure recovery is as complete and rapid as possible.

• #14 Vascular Ring Surgery & Repair: Expert Care at Rady Children’s | Rady Children’s Hospital

  https://www.rchsd.org/programs-services/aerodigestive-vascular-ring-program/

  Vascular ring is a congenital aortic arch anomaly where the aorta and surrounding blood vessels develop abnormally, forming a ring-like structure that encircles the trachea and esophagus. A vascular ring can lead to breathing and swallowing difficulties as well as heart problems. […] Rady Childrens Hospital provides a comprehensive, tailored approach for each patient through our Aerodigestive Vascular Ring Program. A multidisciplinary team of experts from Otolaryngology (ENT), pulmonary, gastroenterology, cardiology, speech-language pathology, occupational therapy, and nutrition will assess your child. […] If surgery is recommended, the cardiovascular surgeon will decide the best approach after reviewing all imaging. Approaches may include: A thoracotomy (accessing the chest wall from the side between the ribs) or A sternotomy (dividing the breastbone to access the chest cavity).

• #15 Pediatric Vascular Ring | Memorial Hermann

  https://memorialhermann.org/services/conditions/pediatric-vascular-ring

  Surgery relieves most symptoms, though sometimes major breathing issues take months to disappear, as the windpipe expands to its natural shape, after having been confined by the vascular ring. […] Children should have regular checkups with their pediatric cardiologist. […] The only treatment for vascular rings is surgery. […] The vascular ring will be disrupted by removing the unneeded arch (if the child has a double aortic arch) or dividing the ligamentum (if the child has right aortic arch with left ligamentum arteriosum). […] With either surgical approach, this dividing of the blood vessel, or “opening” of the vascular ring, relieves the compression on the trachea and esophagus. […] The esophagus is rarely permanently damaged from growing and developing with compression. […] In some older children, the trachea may remain narrowed despite having the vascular ring opened. […] The severity of tracheal narrowing varies from patient to patient, and should be discussed with physicians.

• #16 Vascular Ring Double Aortic Arch – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558938/

  Many surgeons resect the diverticulum for patients with a Kommerell diverticulum and reimplant the left subclavian artery, end to side, with the left common carotid artery. […] A critical part of post-surgery care is the intensivist, who takes care of the patient and then transfers to the pediatrician, who then follows the patient for any complications.

• #17

  https://ctsnet.figshare.com/articles/media/Thoracoscopic_Repair_of_a_Vascular_Ring_Formed_by_a_Right_Aortic_Arch_and_a_Left_Ligamentum_Arteriosum/11825367

  Vascular ring is a congenital anomaly of the aortic arch that compresses the esophagus and/or trachea. It can be asymptomatic for life and not require any intervention. On the contrary, there are some vascular rings that are associated with respiratory (frequent infections, stridor, cough, distress) and esophageal (difficulty feeding, gastroesophageal reflux, dysphagia) symptoms. The most common vascular rings are double aortic arch and right aortic arch with left ligamentum arteriosum. […] The postoperative bronchoscopy in the OR showed clear improvement of the compression. The patient was extubated in the OR. Intensive care unit stay was one day. The postoperative course was uneventful. The patient was discharged home five days after surgery.

• #18 Vascular Rings Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/426233-treatment

  About 10% of infants may continue to have noisy breathing for a while after the surgical procedure; it is important to inform the child’s parents of this possibility. […] Serious surgical complications are rare in most reported surgical series of vascular ring division. Most complications associated with these problems occur in the preoperative setting and may even occur before the diagnosis is known. […] Most patients are essentially asymptomatic within a few weeks after surgery and can resume activity and feedings as tolerated.

• #19 Pediatric Vascular Ring | Cardinal Glennon

  https://www.ssmhealth.com/cardinal-glennon/fetal-care-institute/fetal-heart-program/heart-conditions/vascular-ring

  A Vascular Ring happens during development when the aortic arch or its branches wrap around the babys trachea, the esophagus or both. […] If the Vascular Ring does not squeeze the esophagus or trachea, your baby may not have any symptoms. But, if the ring compresses the trachea or esophagus, it can lead to breathing and digestive challenges. […] Babies with a Vascular Ring will meet with a team of pediatric specialists, including: Cardiologists, who specialize in the heart; Pulmonologists, who specialize in lungs and breathing; Gastroenterologists, who specialize in the digestive system; Ear, nose and throat (ENT) specialists. […] A Vascular Ring that causes symptoms will require surgery. […] After surgery, your baby may have noisy breathing for a few months as the trachea and esophagus transition to their normal shape. […] Overall, the long-term prognosis for children with a Vascular Ring is good. Most babies will not require any additional surgeries for the Vascular Ring.

• #20 FloridaHealthFinder | Vascular ring | Health Encyclopedia | FloridaHealthFinder

  https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/007318

  Surgery is usually performed as soon as possible on children with symptoms. The goal of surgery is to split the vascular ring and relieve pressure on the surrounding structures. The procedure is usually done through a small surgical cut in the left side of the chest between the ribs. […] Changing the child’s diet may help relieve the digestive symptoms of vascular ring. The provider will prescribe medicines (such as antibiotics) to treat any respiratory tract infections, if they occur. […] Children who do not have symptoms may not need treatment but should be carefully watched to make sure the condition does not become worse. […] Contact your provider if your baby has symptoms of vascular ring. Getting diagnosed and treated quickly can prevent serious complications.

• #21 Vascular Ring Symptoms, Diagnosis and Repair

  https://resources.healthgrades.com/right-care/vascular-conditions/vascular-ring

  A vascular ring is a rare vascular irregularity when the aortic arch presses on the trachea and esophagus. It causes respiratory and gastrointestinal symptoms. There are several types of vascular ring. […] Surgery can treat vascular ring when symptoms make surgery necessary. […] If your child is showing symptoms of a vascular ring, it’s important to have them seen by their pediatrician for diagnosis and early treatment. […] Surgery is usually the only way to treat a vascular ring. For children with no symptoms, surgery is unnecessary, and their doctor will continue monitoring their condition. […] Most people, up to 70%, become asymptomatic within a year after surgery. However, respiratory symptoms may persist for 4–6 months after surgery. […] You can help your child cope with the condition by talking with their doctor about ways to manage persistent coughing or other respiratory symptoms. If your child has trouble eating, you can try serving them smaller meals with foods that are easy to swallow. […] Complications of a vascular ring usually affect the trachea and esophagus due to the compression of these structures. Examples of complications include laryngeal nerve injury, vocal cord paralysis, thoracic duct injury, pleural effusion, narrowing of blood vessels, bleeding, and clotting.

• #22 Vascular Rings: Causes and Symptoms

  https://my.clevelandclinic.org/health/diseases/23947-vascular-rings

  A vascular ring is a congenital heart defect that can cause problems with breathing or eating. […] A vascular ring is a congenital defect, meaning it’s present at birth. The condition can be life-threatening, but surgery is usually successful. […] Vascular rings that are pressing on your trachea or esophagus require surgery. […] Surgery to correct a vascular ring is quite safe and often successful. Although you or your child may have symptoms for a few months afterward, most people are symptom-free within a year of surgery. […] A vascular ring is an abnormal formation of the aorta that presses on the trachea, esophagus or both. The congenital defect can cause problems with breathing or eating. If you or your child has a vascular ring, surgery can correct the condition and eliminate symptoms. […] Cleveland Clinic Childrens providers treat vascular rings in babies and children with compassionate support and excellent results.

• #23 Vascular Ring and Airway Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/vascular-ring-and-airway

  If surgery is recommended, we often recommend baseline studies. […] Our program and approach to these problems are unique. […] It is important to note that the final surgical recommendation is patient-specific and based on each childs anatomy. […] Our team also closely monitors patients over the long term after surgery. […] Following discharge, we will closely follow your child through in-person or virtual visits, ensuring they are recovering well and so that we can be available to your family as needed.

• #24 Vascular Ring Surgery & Repair: Expert Care at Rady Children’s | Rady Children’s Hospital

  https://www.rchsd.org/programs-services/aerodigestive-vascular-ring-program/

  After your childs surgery, our health care professionals continue to manage your childs care through our outpatient clinic to ensure improvements in breathing and feeding for optimal success. […] Ongoing monitoring and follow-up in our outpatient clinic to ensure improvements in breathing, feeding, and overall health.

• #25 Vascular rings | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/vascular-rings?content_id=CON-20359711

  A vascular ring can affect breathing and swallowing. Surgery is usually needed to treat a vascular ring. […] People born with vascular rings need regular health checkups for life to prevent complications. It’s best to be cared for by a healthcare professional trained in congenital heart conditions. These types of doctors are called congenital cardiologists.

• #26 Vascular rings

  https://www.mymlc.com/health-information/diseases-and-conditions/v/vascular-rings/?section=Diagnosis

  Children and adults with vascular rings may need lifelong care and regular follow-up appointments with specialists to monitor their conditions. Multiple specialists, including congenital cardiologists, doctors trained in lung conditions (pulmonologists), doctors trained in digestive conditions (gastroenterologists), and doctors trained in ear, nose and throat conditions may be involved in their care.

• #27 Vascular Ring | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vascular-ring

  Our pediatric cardiologists will follow your child until she is a young adult, coordinating care with her primary care physician. She will need to carefully follow the medical teams advice. […] Children born with vascular rings who do not require surgery should follow up with a cardiologist. We will help patients transition care to an adult cardiologist.

• #28 Vascular Ring | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/vascular-ring

  A vascular ring occurs when a childs aorta the bodys largest blood vessel or its branches form abnormally, so that they encircle and constrict the trachea and usually the esophagus. This compression can cause breathing and swallowing problems. […] The clinicians at Boston Childrens Vascular Ring and Airway Program and the Esophageal and Airway Treatment Center work together to provide collaborative care and, when necessary, surgery for children with vascular rings and airway or esophageal compression. […] Here are some of the proven, cutting-edge surgical techniques our specialists use to treat vascular rings. […] Boston Childrens is one of the few hospitals to repair vascular rings with a combination of these procedures in one comprehensive surgical procedure. Treating a child with just one operation ensures that the condition is treated thoroughly and prevents the need for future procedures. […] If a patients surgery did not address the vascular ring completely, they may have recurrent symptoms and require another operation.

• #29 Multidisciplinary approach to vascular rings and vascular-related aerodigestive compression: a clinical practice review – Chiu – Translational Pediatrics

  https://tp.amegroups.org/article/view/114864/html

  Vascular rings, including double aortic arch and right aortic arch with aberrant left subclavian and left ligamentum, are part of a larger group of vascular-related aerodigestive compression syndromes that also includes innominate artery compression syndrome, dysphagia lusoria, aortic arch anomalies, and aneurysms of either the aorta or pulmonary artery. […] The approach to the diagnosis and management of these varied phenomena has been streamlined by the multidisciplinary team at Boston Childrens Hospital. […] The comprehensive care of these patients requires the coordinated efforts of a large team of dedicated personnel in order to achieve the optimal result. […] Despite the substantial variability in etiologies and presentations, a multidisciplinary approach to diagnostic evaluation has been standardized at Boston Childrens Hospital.

• #30 Multidisciplinary approach to vascular rings and vascular-related aerodigestive compression: a clinical practice review – Chiu – Translational Pediatrics

  https://tp.amegroups.org/article/view/114864/html

  Our group performs a three-phase bronchoscopy under general anesthesia without muscle relaxation. […] The goal of posterior tracheobronchopexy is to fix the membranous trachea in place. […] Our approach at the initial operation has evolved to include liberal use of tracheobronchopexy under bronchoscopic guidance for patients with tracheobronchomalacia and significant respiratory symptoms. […] In order to achieve this, we will often employ the Munoz maneuver (negative suction test) intraoperatively in order to assess the effect of dynamic collapse following tracheobronchopexy. […] The incidence of vocal cord dysfunction appears to be directly related to whether screening is limited to symptomatic patients or if all patients are universally screened. […] Given that many seemingly asymptomatic patients may experience silent aspiration, it is our practice to routinely screen all patients before and after each operation. […] Our programmatic approach has been to work with the otorhinolaryngologists to perform routine preoperative and postoperative vocal fold assessment.

• #31 Vascular Rings | Mount Sinai – New York

  https://www.mountsinai.org/locations/childrens-heart/conditions/vascular-rings

  When you hear that your child was born with a vascular ring, you may be concerned. A vascular ring is a birth defect where the blood vessels in the chest can press on and narrow your child’s feeding tube or windpipe. […] At Mount Sinai Kravis Children’s Heart Center our pediatric cardiologists are highly trained, extremely skilled, and very experienced. We diagnose and treat all types of heart conditions in children of all ages. This includes all types of vascular rings. […] If your child is having symptoms, or if we are worried about narrowing of the airway, we may need to perform surgery. If your child has no symptoms, we may not need to, though we may continue to monitor them. Often, when performing surgery, we can use a minimally invasive procedure which means fewer complications and quicker recovery for your little one. […] Your child’s cardiologist and surgeon will explain your child’s specific situation and the treatment needed. […] We monitor your child after the procedure to make sure recovery is complete and quick. Most children don’t need additional procedures after surgical treatment.

• #32 Pediatric vascular ring outcomes for surgically repaired vs. unoperated children: a single-center experience – Ajdaa – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/86251/html

  Most patients were symptomatic at the time of diagnosis. […] Vascular rings such as pulmonary slings or tracheal compression syndromes require prompt management. […] Despite surgery, 24% of patients were not symptom-free at follow-up. […] Finally, surgery in asymptomatic patients resulted in low morbidity supporting the current recommendation of early surgical repair. […] This study demonstrates that vascular ring repair is safe in asymptomatic patients. […] Following a thorough preoperative evaluation to rule out concomitant tracheobronchomalacia, a tailored surgical approach can be offered to symptomatic and asymptomatic vascular ring patients, from simple ligamentum arteriosus division to complete Kommerell diverticulum resection and subclavian artery reimplantation.

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