Materiały źródłowe

• #1 Vascular Ring Surgical Repair: Re-Implantation of the Left Subclavian Artery into the Left Carotid Artery in a Pediatric Patient

  https://www.mdpi.com/2075-4418/14/16/1736

  Vascular rings have an estimated prevalence of 1 in 10,000 live births. These rare congenital anomalies of the aortic arch encircle and compress the trachea and/or esophagus, presenting as nonspecific symptoms that vary in severity depending on the affected structure and the degree of compression. Early surgical intervention is crucial in symptomatic vascular rings. Surgical repair focuses on relieving tracheal and/or esophageal compression by dividing the vascular ring, thereby providing symptomatic relief and preventing serious complications, such as sudden death or residual tracheobronchial damage. […] Early surgical repair of symptomatic vascular rings is crucial, aiming to relieve the compression while reducing the associated potential complications. […] The surgical repair of vascular rings has a very low risk of morbidity and mortality, with favorable mid- and long-term outcomes. The obliteration of the KD and reimplantation of the LSA achieve good outcomes in eliminating respiratory and esophageal symptoms after the vascular ring repair.

• #2 Treatment of Symptomatic Vascular Rings in the Elderly

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1336722/

  Vascular rings are developmental abnormalities involving partial or complete encirclement of the trachea or esophagus by the aortic arch, which can cause pressure symptoms of respiratory distress or dysphagia. […] Symptomatic vascular rings require operative intervention. Relief of symptoms follows surgical correction, in most cases. […] Surgical intervention is indicated in all patients who present with symptomatic vascular rings. The surgical approach to these lesions can be via either thoracotomy or sternotomy. […] In conclusion, extrinsic compression by a vascular ring is extremely rare and can present with vague symptoms or with overt evidence of tracheal or esophageal obstruction. Awareness of vascular rings as a potential cause of these symptoms in the elderly avoids misdiagnosis and treatment delay.

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

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

  A vascular ring occurs when the aorta (the bodys largest blood vessel) or its branches develop abnormally, encircling and, in some cases, obstructing the trachea and esophagus. […] Treatment of vascular rings requires a variety of advanced diagnostic and therapeutic techniques by a team of physicians experienced in cardiovascular, esophageal, and airway surgery. […] This unique collaborative effort helps to ensure that the condition is treated thoroughly with the goal of preventing the need for future operations. […] Our team also monitors for symptoms in children who are not designated for surgery, ensuring an appropriate treatment can be immediately pursued if surgery is eventually necessary and also to assess symptoms that are not directly related to the vascular ring. […] The recommendations from our conference can include monitoring symptoms, obtaining additional testing, or pursuing a surgical repair of the vascular ring.

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

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

  There is no known way to prevent this condition. […] Contact your provider if your baby has symptoms of vascular ring. Getting diagnosed and treated quickly can prevent serious complications.

• #5 Vascular Rings: Causes and Symptoms

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

  Scientists dont understand what causes vascular rings to form as a fetus develops, so there are no strategies to prevent them. […] 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.

• #6 Get Vascular Rings Treatment | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/vascular-rings-treatment

  We cant prevent vascular rings from developing. But we can treat them. […] If vascular rings press on your childs esophagus or trachea, theyll likely need surgery. Depending on how bad the symptoms are (and if they have a double aortic arch), our surgeons may operate right away. If they dont have symptoms, we may take a watchful waiting approach and keep a close eye on things as your child grows.

• #7 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/

  Doctors think that vascular rings occur early in pregnancy when the baby is developing in the womb. They do not think it was caused by anything you did or did not do during pregnancy. […] Your baby will probably not have any symptoms after birth, but we will arrange for your baby to be checked by a cardiologist after delivery. […] If the ring is tight enough to cause problems you may notice: Noisy breathing if the trachea is compressed; Difficulty swallowing, particularly when the baby is weaned from milk to solids, if the oesophagus is compressed. […] Your baby will have an ultrasound scan in the first few weeks after birth, so that the vascular ring can be assessed. […] Some babies may have to have an operation to release and rearrange the vessels so that the trachea and oesophagus are no longer compressed.

• #8 Understanding Vascular Ring Anomaly • MSPCA-Angell

  https://www.mspca.org/angell_services/understanding-vascular-ring-anomaly/

  Vascular ring anomalies are congenital malformations of the major blood vessels of the body that result in esophageal entrapment and constriction. […] As such, affected animals and unaffected animals coming from litters that contain affected animals should not be bred. […] The treatment of choice is surgical intervention in which the aberrant vessel is ligated and transected alleviating the esophageal constriction. This should be performed as soon as possible after diagnosis in order to reduce the degree of damage to the esophageal muscles and nerves. […] A worse prognosis is associated with severity of esophageal dilation and greater time delay to surgery. […] While medical management can be attempted through elevated feedings of a liquid diet, this is palliative, and the affected animal will continue to have chronic regurgitation, worsening episodes of aspiration pneumonia and failure to thrive due to the inability to consume an appropriate amount of calories. Thus, long term prognosis is poor with this treatment option.

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

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

  There is no known way to prevent this condition. […] Contact your provider if your baby has symptoms of vascular ring. Getting diagnosed and treated quickly can prevent serious complications.

• #10 Vascular Ring Symptoms, Diagnosis and Repair

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

  There is no way to prevent a vascular ring, but early recognition of symptoms can help prompt the right form of treatment. […] 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.

• #11 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/

  Doctors think that vascular rings occur early in pregnancy when the baby is developing in the womb. They do not think it was caused by anything you did or did not do during pregnancy. […] Your baby will probably not have any symptoms after birth, but we will arrange for your baby to be checked by a cardiologist after delivery. […] If the ring is tight enough to cause problems you may notice: Noisy breathing if the trachea is compressed; Difficulty swallowing, particularly when the baby is weaned from milk to solids, if the oesophagus is compressed. […] Your baby will have an ultrasound scan in the first few weeks after birth, so that the vascular ring can be assessed. […] Some babies may have to have an operation to release and rearrange the vessels so that the trachea and oesophagus are no longer compressed.

• #12 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/

  Doctors think that vascular rings occur early in pregnancy when the baby is developing in the womb. They do not think it was caused by anything you did or did not do during pregnancy. […] Your baby will probably not have any symptoms after birth, but we will arrange for your baby to be checked by a cardiologist after delivery. […] If the ring is tight enough to cause problems you may notice: Noisy breathing if the trachea is compressed; Difficulty swallowing, particularly when the baby is weaned from milk to solids, if the oesophagus is compressed. […] Your baby will have an ultrasound scan in the first few weeks after birth, so that the vascular ring can be assessed. […] Some babies may have to have an operation to release and rearrange the vessels so that the trachea and oesophagus are no longer compressed.

• #13 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/

  Doctors think that vascular rings occur early in pregnancy when the baby is developing in the womb. They do not think it was caused by anything you did or did not do during pregnancy. […] Your baby will probably not have any symptoms after birth, but we will arrange for your baby to be checked by a cardiologist after delivery. […] If the ring is tight enough to cause problems you may notice: Noisy breathing if the trachea is compressed; Difficulty swallowing, particularly when the baby is weaned from milk to solids, if the oesophagus is compressed. […] Your baby will have an ultrasound scan in the first few weeks after birth, so that the vascular ring can be assessed. […] Some babies may have to have an operation to release and rearrange the vessels so that the trachea and oesophagus are no longer compressed.

• #14 Vascular Ring: Does Your Child Have the Symptoms? – Urgent Heart Clinic for Kids and Adults- Dr. Nancy Hua Pediatric Cardiologist

  https://pedshappyhearts.com/2023/12/13/vascular-ring-what-parents-need-to-know/

  It is important to note that parents of children suspected to have vascular rings should seek prompt medical attention from healthcare professionals for accurate diagnosis and appropriate treatment. Early intervention is critical to preventing complications and improving outcomes. […] Thus, parents and caregivers should be aware of the signs and symptoms of vascular rings and seek prompt medical attention if they suspect their child may be affected. With proper diagnosis and treatment, healthcare professionals can help patients with vascular rings lead healthy and fulfilling lives.

• #15 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. […] Surgery should not be delayed in the presence of a respiratory tract infection, because the division of the ring allows more adequate and complete clearing of respiratory secretions. […] 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.

• #16

  https://step2.medbullets.com/evidence/31676999

  A vascular ring is a rare congenital cardiovascular anomaly, which encircles and compresses the trachea or esophagus, or both. […] Symptomatic vascular rings require early surgical intervention to prevent prolonged vascular compression of the airway and serious complications.

• #17 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. […] Surgery should not be delayed in the presence of a respiratory tract infection, because the division of the ring allows more adequate and complete clearing of respiratory secretions. […] 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.

• #18 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. […] Surgery should not be delayed in the presence of a respiratory tract infection, because the division of the ring allows more adequate and complete clearing of respiratory secretions. […] 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.

• #19 Understanding Vascular Ring Anomaly • MSPCA-Angell

  https://www.mspca.org/angell_services/understanding-vascular-ring-anomaly/

  Vascular ring anomalies are congenital malformations of the major blood vessels of the body that result in esophageal entrapment and constriction. […] As such, affected animals and unaffected animals coming from litters that contain affected animals should not be bred. […] The treatment of choice is surgical intervention in which the aberrant vessel is ligated and transected alleviating the esophageal constriction. This should be performed as soon as possible after diagnosis in order to reduce the degree of damage to the esophageal muscles and nerves. […] A worse prognosis is associated with severity of esophageal dilation and greater time delay to surgery. […] While medical management can be attempted through elevated feedings of a liquid diet, this is palliative, and the affected animal will continue to have chronic regurgitation, worsening episodes of aspiration pneumonia and failure to thrive due to the inability to consume an appropriate amount of calories. Thus, long term prognosis is poor with this treatment option.

• #20 Vascular Ring Surgical Repair: Re-Implantation of the Left Subclavian Artery into the Left Carotid Artery in a Pediatric Patient

  https://www.mdpi.com/2075-4418/14/16/1736

  Vascular rings have an estimated prevalence of 1 in 10,000 live births. These rare congenital anomalies of the aortic arch encircle and compress the trachea and/or esophagus, presenting as nonspecific symptoms that vary in severity depending on the affected structure and the degree of compression. Early surgical intervention is crucial in symptomatic vascular rings. Surgical repair focuses on relieving tracheal and/or esophageal compression by dividing the vascular ring, thereby providing symptomatic relief and preventing serious complications, such as sudden death or residual tracheobronchial damage. […] Early surgical repair of symptomatic vascular rings is crucial, aiming to relieve the compression while reducing the associated potential complications. […] The surgical repair of vascular rings has a very low risk of morbidity and mortality, with favorable mid- and long-term outcomes. The obliteration of the KD and reimplantation of the LSA achieve good outcomes in eliminating respiratory and esophageal symptoms after the vascular ring repair.

• #21

  https://abc.com/news/5ffba197-63fb-484f-9d42-5c53749179df/category/740480

  Cristina’s patient Katy was born with a „vascular ring.” Which is what, we all ask? Relatively rare, a vascular ring is a type of congenital defect that can be defined by an atypical formation of the aorta and its surrounding blood vessels. […] Do all patients with vascular rings need surgical treatment? If a patient is symptomatic or develops a complication (like in Katy’s case with her large aneurysm), surgery to divide the ring is almost always indicated. The operative goal is to open the closed ring with acceptance that many of the vessels may still have an abnormal course. But as long as one part of the ring now is open, the trachea and esophagus will no longer be constricted, providing relief to many of the symptoms.

• #22

  https://abc.com/news/5ffba197-63fb-484f-9d42-5c53749179df/category/740480

  Cristina’s patient Katy was born with a „vascular ring.” Which is what, we all ask? Relatively rare, a vascular ring is a type of congenital defect that can be defined by an atypical formation of the aorta and its surrounding blood vessels. […] Do all patients with vascular rings need surgical treatment? If a patient is symptomatic or develops a complication (like in Katy’s case with her large aneurysm), surgery to divide the ring is almost always indicated. The operative goal is to open the closed ring with acceptance that many of the vessels may still have an abnormal course. But as long as one part of the ring now is open, the trachea and esophagus will no longer be constricted, providing relief to many of the symptoms.

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

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

  Preoperative airway management is of paramount importance in these patients, especially those presenting with severe respiratory problems very early in life. […] Immediate postoperative management after division of a vascular ring is performed in an intensive care unit (ICU). […] 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. […] Most patients are essentially asymptomatic within a few weeks after surgery and can resume activity and feedings as tolerated. […] A small group continues to have some symptoms postoperatively; however, these findings are less prominent than those noted preoperatively in the majority of cases.

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

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

  Preoperative airway management is of paramount importance in these patients, especially those presenting with severe respiratory problems very early in life. […] Immediate postoperative management after division of a vascular ring is performed in an intensive care unit (ICU). […] 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. […] Most patients are essentially asymptomatic within a few weeks after surgery and can resume activity and feedings as tolerated. […] A small group continues to have some symptoms postoperatively; however, these findings are less prominent than those noted preoperatively in the majority of cases.

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

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

  Preoperative airway management is of paramount importance in these patients, especially those presenting with severe respiratory problems very early in life. […] Immediate postoperative management after division of a vascular ring is performed in an intensive care unit (ICU). […] 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. […] Most patients are essentially asymptomatic within a few weeks after surgery and can resume activity and feedings as tolerated. […] A small group continues to have some symptoms postoperatively; however, these findings are less prominent than those noted preoperatively in the majority of cases.

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

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

  Preoperative airway management is of paramount importance in these patients, especially those presenting with severe respiratory problems very early in life. […] Immediate postoperative management after division of a vascular ring is performed in an intensive care unit (ICU). […] 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. […] Most patients are essentially asymptomatic within a few weeks after surgery and can resume activity and feedings as tolerated. […] A small group continues to have some symptoms postoperatively; however, these findings are less prominent than those noted preoperatively in the majority of cases.

• #27 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.

• #28 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. […] Surgery should not be delayed in the presence of a respiratory tract infection, because the division of the ring allows more adequate and complete clearing of respiratory secretions. […] 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.

• #29 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.

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

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

  A vascular ring occurs when the aorta (the bodys largest blood vessel) or its branches develop abnormally, encircling and, in some cases, obstructing the trachea and esophagus. […] Treatment of vascular rings requires a variety of advanced diagnostic and therapeutic techniques by a team of physicians experienced in cardiovascular, esophageal, and airway surgery. […] This unique collaborative effort helps to ensure that the condition is treated thoroughly with the goal of preventing the need for future operations. […] Our team also monitors for symptoms in children who are not designated for surgery, ensuring an appropriate treatment can be immediately pursued if surgery is eventually necessary and also to assess symptoms that are not directly related to the vascular ring. […] The recommendations from our conference can include monitoring symptoms, obtaining additional testing, or pursuing a surgical repair of the vascular ring.

• #31 Get Vascular Rings Treatment | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/vascular-rings-treatment

  We cant prevent vascular rings from developing. But we can treat them. […] If vascular rings press on your childs esophagus or trachea, theyll likely need surgery. Depending on how bad the symptoms are (and if they have a double aortic arch), our surgeons may operate right away. If they dont have symptoms, we may take a watchful waiting approach and keep a close eye on things as your child grows.

• #32 Vascular rings | Beacon Health System

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

  Surgery usually is done to treat a vascular ring that presses against the trachea or esophagus. Surgery also helps prevent complications. […] 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.

• #33 Vascular rings | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20359711/

  Surgery usually is done to treat a vascular ring that presses against the trachea or esophagus. Surgery also helps prevent complications. […] People born with vascular rings need regular health checkups for life to prevent complications. Its best to be cared for by a healthcare professional trained in congenital heart conditions. These types of doctors are called congenital cardiologists.

• #34 Vascular rings | Beacon Health System

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

  Surgery usually is done to treat a vascular ring that presses against the trachea or esophagus. Surgery also helps prevent complications. […] 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.

• #35 Vascular Ring Surgical Repair: Re-Implantation of the Left Subclavian Artery into the Left Carotid Artery in a Pediatric Patient

  https://www.mdpi.com/2075-4418/14/16/1736

  After repairing the defect, patients should be followed up with regular clinic evaluations to assess symptomatic improvement and exclude postoperative complications. Imaging studies should be conducted to ensure the patency of the LSA reimplantation and the absence of tracheal deformities or esophageal narrowing. Specifically, patients should return for control visits at 1-, 3-, 6-, and 12-months post-surgery, and then annually if no complications arise. Precautions include monitoring for respiratory or swallowing difficulties and regular imaging to ensure there is no recurrence of compression or other complications. It is recommended to continue regular follow-ups throughout life, especially during periods of rapid growth.

• #36 Vascular Ring Surgical Repair: Re-Implantation of the Left Subclavian Artery into the Left Carotid Artery in a Pediatric Patient

  https://www.mdpi.com/2075-4418/14/16/1736

  After repairing the defect, patients should be followed up with regular clinic evaluations to assess symptomatic improvement and exclude postoperative complications. Imaging studies should be conducted to ensure the patency of the LSA reimplantation and the absence of tracheal deformities or esophageal narrowing. Specifically, patients should return for control visits at 1-, 3-, 6-, and 12-months post-surgery, and then annually if no complications arise. Precautions include monitoring for respiratory or swallowing difficulties and regular imaging to ensure there is no recurrence of compression or other complications. It is recommended to continue regular follow-ups throughout life, especially during periods of rapid growth.

• #37 Vascular Ring Surgical Repair: Re-Implantation of the Left Subclavian Artery into the Left Carotid Artery in a Pediatric Patient

  https://www.mdpi.com/2075-4418/14/16/1736

  After repairing the defect, patients should be followed up with regular clinic evaluations to assess symptomatic improvement and exclude postoperative complications. Imaging studies should be conducted to ensure the patency of the LSA reimplantation and the absence of tracheal deformities or esophageal narrowing. Specifically, patients should return for control visits at 1-, 3-, 6-, and 12-months post-surgery, and then annually if no complications arise. Precautions include monitoring for respiratory or swallowing difficulties and regular imaging to ensure there is no recurrence of compression or other complications. It is recommended to continue regular follow-ups throughout life, especially during periods of rapid growth.

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

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

  It is important to note that the final surgical recommendation is patient-specific and based on each childs anatomy. […] Each patient is evaluated for not only fixing the vascular ring anatomy itself, but also the potential need for additional interventions of the airway and esophagus. […] Our team also closely monitors patients over the long term after surgery. It is critical to monitor symptoms after a surgical repair to ensure surgery is durable and that a patient has the best possible recovery.

• #39 Vascular Rings Program | Lurie Children’s

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

  Lurie Children’s Vascular Ring Program treats children with severe vascular rings, using innovative and proven surgical methods to relieve pressure on the trachea and esophagus. […] We have pioneered procedures such as Kommerells diverticulum excision, along with division of an associated vascular ring, to prevent enlargement of the diverticulum over time with recurrence of symptoms of obstructed breathing or difficulty swallowing. […] The results of vascular ring surgery are excellent we have not had an operative mortality rate in the past 30 years and more than 90% of our patients see their symptoms resolve.

• #40 Vascular Ring Surgical Repair: Re-Implantation of the Left Subclavian Artery into the Left Carotid Artery in a Pediatric Patient

  https://www.mdpi.com/2075-4418/14/16/1736

  Vascular rings have an estimated prevalence of 1 in 10,000 live births. These rare congenital anomalies of the aortic arch encircle and compress the trachea and/or esophagus, presenting as nonspecific symptoms that vary in severity depending on the affected structure and the degree of compression. Early surgical intervention is crucial in symptomatic vascular rings. Surgical repair focuses on relieving tracheal and/or esophageal compression by dividing the vascular ring, thereby providing symptomatic relief and preventing serious complications, such as sudden death or residual tracheobronchial damage. […] Early surgical repair of symptomatic vascular rings is crucial, aiming to relieve the compression while reducing the associated potential complications. […] The surgical repair of vascular rings has a very low risk of morbidity and mortality, with favorable mid- and long-term outcomes. The obliteration of the KD and reimplantation of the LSA achieve good outcomes in eliminating respiratory and esophageal symptoms after the vascular ring repair.

• #41 Vascular Rings Program | Lurie Children’s

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

  Lurie Children’s Vascular Ring Program treats children with severe vascular rings, using innovative and proven surgical methods to relieve pressure on the trachea and esophagus. […] We have pioneered procedures such as Kommerells diverticulum excision, along with division of an associated vascular ring, to prevent enlargement of the diverticulum over time with recurrence of symptoms of obstructed breathing or difficulty swallowing. […] The results of vascular ring surgery are excellent we have not had an operative mortality rate in the past 30 years and more than 90% of our patients see their symptoms resolve.

• #42 Understanding Vascular Ring Anomaly • MSPCA-Angell

  https://www.mspca.org/angell_services/understanding-vascular-ring-anomaly/

  Vascular ring anomalies are congenital malformations of the major blood vessels of the body that result in esophageal entrapment and constriction. […] As such, affected animals and unaffected animals coming from litters that contain affected animals should not be bred. […] The treatment of choice is surgical intervention in which the aberrant vessel is ligated and transected alleviating the esophageal constriction. This should be performed as soon as possible after diagnosis in order to reduce the degree of damage to the esophageal muscles and nerves. […] A worse prognosis is associated with severity of esophageal dilation and greater time delay to surgery. […] While medical management can be attempted through elevated feedings of a liquid diet, this is palliative, and the affected animal will continue to have chronic regurgitation, worsening episodes of aspiration pneumonia and failure to thrive due to the inability to consume an appropriate amount of calories. Thus, long term prognosis is poor with this treatment option.

• #43 Understanding Vascular Ring Anomaly • MSPCA-Angell

  https://www.mspca.org/angell_services/understanding-vascular-ring-anomaly/

  Vascular ring anomalies are congenital malformations of the major blood vessels of the body that result in esophageal entrapment and constriction. […] As such, affected animals and unaffected animals coming from litters that contain affected animals should not be bred. […] The treatment of choice is surgical intervention in which the aberrant vessel is ligated and transected alleviating the esophageal constriction. This should be performed as soon as possible after diagnosis in order to reduce the degree of damage to the esophageal muscles and nerves. […] A worse prognosis is associated with severity of esophageal dilation and greater time delay to surgery. […] While medical management can be attempted through elevated feedings of a liquid diet, this is palliative, and the affected animal will continue to have chronic regurgitation, worsening episodes of aspiration pneumonia and failure to thrive due to the inability to consume an appropriate amount of calories. Thus, long term prognosis is poor with this treatment option.

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

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

  A vascular ring occurs when the aorta (the bodys largest blood vessel) or its branches develop abnormally, encircling and, in some cases, obstructing the trachea and esophagus. […] Treatment of vascular rings requires a variety of advanced diagnostic and therapeutic techniques by a team of physicians experienced in cardiovascular, esophageal, and airway surgery. […] This unique collaborative effort helps to ensure that the condition is treated thoroughly with the goal of preventing the need for future operations. […] Our team also monitors for symptoms in children who are not designated for surgery, ensuring an appropriate treatment can be immediately pursued if surgery is eventually necessary and also to assess symptoms that are not directly related to the vascular ring. […] The recommendations from our conference can include monitoring symptoms, obtaining additional testing, or pursuing a surgical repair of the vascular ring.

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

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

  A vascular ring occurs when the aorta (the bodys largest blood vessel) or its branches develop abnormally, encircling and, in some cases, obstructing the trachea and esophagus. […] Treatment of vascular rings requires a variety of advanced diagnostic and therapeutic techniques by a team of physicians experienced in cardiovascular, esophageal, and airway surgery. […] This unique collaborative effort helps to ensure that the condition is treated thoroughly with the goal of preventing the need for future operations. […] Our team also monitors for symptoms in children who are not designated for surgery, ensuring an appropriate treatment can be immediately pursued if surgery is eventually necessary and also to assess symptoms that are not directly related to the vascular ring. […] The recommendations from our conference can include monitoring symptoms, obtaining additional testing, or pursuing a surgical repair of the vascular ring.

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

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

  It is important to note that the final surgical recommendation is patient-specific and based on each childs anatomy. […] Each patient is evaluated for not only fixing the vascular ring anatomy itself, but also the potential need for additional interventions of the airway and esophagus. […] Our team also closely monitors patients over the long term after surgery. It is critical to monitor symptoms after a surgical repair to ensure surgery is durable and that a patient has the best possible recovery.

• #47 Vascular Ring: Does Your Child Have the Symptoms? – Urgent Heart Clinic for Kids and Adults- Dr. Nancy Hua Pediatric Cardiologist

  https://pedshappyhearts.com/2023/12/13/vascular-ring-what-parents-need-to-know/

  It is important to note that parents of children suspected to have vascular rings should seek prompt medical attention from healthcare professionals for accurate diagnosis and appropriate treatment. Early intervention is critical to preventing complications and improving outcomes. […] Thus, parents and caregivers should be aware of the signs and symptoms of vascular rings and seek prompt medical attention if they suspect their child may be affected. With proper diagnosis and treatment, healthcare professionals can help patients with vascular rings lead healthy and fulfilling lives.

• #48 Vascular Ring: Does Your Child Have the Symptoms? – Urgent Heart Clinic for Kids and Adults- Dr. Nancy Hua Pediatric Cardiologist

  https://pedshappyhearts.com/2023/12/13/vascular-ring-what-parents-need-to-know/

  It is important to note that parents of children suspected to have vascular rings should seek prompt medical attention from healthcare professionals for accurate diagnosis and appropriate treatment. Early intervention is critical to preventing complications and improving outcomes. […] Thus, parents and caregivers should be aware of the signs and symptoms of vascular rings and seek prompt medical attention if they suspect their child may be affected. With proper diagnosis and treatment, healthcare professionals can help patients with vascular rings lead healthy and fulfilling lives.

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

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

  There is no known way to prevent this condition. […] Contact your provider if your baby has symptoms of vascular ring. Getting diagnosed and treated quickly can prevent serious complications.

• #50 Vascular rings | Beacon Health System

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

  Surgery usually is done to treat a vascular ring that presses against the trachea or esophagus. Surgery also helps prevent complications. […] 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.

• #51 Treatment of Symptomatic Vascular Rings in the Elderly

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1336722/

  Vascular rings are developmental abnormalities involving partial or complete encirclement of the trachea or esophagus by the aortic arch, which can cause pressure symptoms of respiratory distress or dysphagia. […] Symptomatic vascular rings require operative intervention. Relief of symptoms follows surgical correction, in most cases. […] Surgical intervention is indicated in all patients who present with symptomatic vascular rings. The surgical approach to these lesions can be via either thoracotomy or sternotomy. […] In conclusion, extrinsic compression by a vascular ring is extremely rare and can present with vague symptoms or with overt evidence of tracheal or esophageal obstruction. Awareness of vascular rings as a potential cause of these symptoms in the elderly avoids misdiagnosis and treatment delay.

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

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

  A vascular ring occurs when the aorta (the bodys largest blood vessel) or its branches develop abnormally, encircling and, in some cases, obstructing the trachea and esophagus. […] Treatment of vascular rings requires a variety of advanced diagnostic and therapeutic techniques by a team of physicians experienced in cardiovascular, esophageal, and airway surgery. […] This unique collaborative effort helps to ensure that the condition is treated thoroughly with the goal of preventing the need for future operations. […] Our team also monitors for symptoms in children who are not designated for surgery, ensuring an appropriate treatment can be immediately pursued if surgery is eventually necessary and also to assess symptoms that are not directly related to the vascular ring. […] The recommendations from our conference can include monitoring symptoms, obtaining additional testing, or pursuing a surgical repair of the vascular ring.

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