Surgical management of congenital vascular rings

Arciniegas, Eduardo; Hakimi, Mehdi; Hertzler, Jack H.; Farooki, Zia Q.; Green, Edward W.

doi:10.1016/s0022-5223(19)38223-6

Cited by 76 publications

(34 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Double aortic arches reportedly manifest earlier than other varieties of vascular rings and have symptoms of stridor, dyspnea, cough, and recurrent respiratory infections. [21,24,25] In this study the long interval between the first onset of symptoms and the surgery was due to the delay in establishing the correct diagnosis. This was primarily caused by the ambiguous nature of the symptoms associated with DAA, which commonly leads physicians to diagnose this phenomenon as a respiratory tract infection or metabolic disease that is responsible for the patient's inability to gain weight.…”

Section: Discussionmentioning

confidence: 78%

Surgical treatment of double aortic arch

Harmandar¹,

Aydemir²,

Karaci³

et al. 2014

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

Bu çalışmada, izole çift arkus aort (ÇAA) olgularında tedavi yaklaşımı ve cerrahi sonrası sonuçları tanımlandı. Ça lış mapla nı:Ocak 2006-Ocak 2012 tarihleri arasında ÇAA nedeniyle ameliyat edilen 11 hastanın (8 kız, 3 erkek; ort. yaş 18.6 ay) başvuru bilgileri, tedavileri ve ameliyat sonuçları ile ilgili veriler retrospektif olarak değerlendirildi. Semptomların düzelme süresi takip dönemi boyunca kaydedildi. Bul gu lar: Semptomların başlangıcında ortalama yaş 3.5 aydı (doğumdan 4 yaşa kadar). Gastrointestinal semptomlar tüm hastalarda mevcutken respiratuar semptomlar hastaların %45.5'inde bulunmaktaydı ve en sık görülen semptomlar sırasıyla beslenme güçlüğü ve tekrarlayan solunum yolu enfeksiyonlarıydı. Tüm hastalara düzeltici cerrahi başarıyla uygulandı. Erken veya geç ölüm meydana gelmedi. Takiplerde yeniden cerrahi ihtiyacı olmadı. Gastrointestinal sistemi içeren semptomlar tüm hastalarda (%100) ortalama 6.4±4.3 ayda düzelirken respiratuar semptomlar dört hastada (%80) ortalama 11.4±7.2 ayda düzeldi. So nuç: Günümüzde, ÇAA'nın cerrahi tedavisinin sonuçları tatmin edicidir. Cerrahi sonrasında, yaştan bağımsız olarak tüm hastalarda gastrointestinal semptomlar kaybolurken respiratuar semptomların tam düzelmesi için erken girişim yapılması gerekmektedir. Anah tar söz cük ler: Çift aort arkı; özofagus darlığı; trakea darlığı; vasküler halka. Background:This study aims to describe the management and surgical outcomes of patients with isolated double aortic arch (DAA). Methods: Data regarding presentation, management, and surgical outcomes of 11 patients (8 girls, 3 boys; median age of 18.6 months) operated between January 2006 and January 2012 due to DAA were evaluated retrospectively. Duration of the reversal of symptoms was recorded throughout the follow-up period. Results: The median age at the onset of symptoms was 3.5 months (birth to 4 years). Gastrointestinal symptoms were present in all and respiratory symptoms were present in 45.5% of patients, with difficulty in feeding and recurrent respiratory tract infections being the most common symptoms, respectively. All patients underwent corrective surgery successfully. No early or late death occurred. No reoperations were required during follow-ups. Symptoms involving gastrointestinal tract disappeared in all patients (100%) in mean 6.4±4.3 months, whereas respiratory symptoms disappeared in four patients (80%) in 11.4±7.2 months. Conclusion:Today, results of surgical treatment of DAA are satisfying. Following surgery, while gastrointestinal symptoms disappeared in all patients regardless of age, complete relief of respiratory symptoms requires early intervention.

show abstract

Section: Discussionmentioning

confidence: 78%

Surgical treatment of double aortic arch

Harmandar¹,

Aydemir²,

Karaci³

et al. 2014

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

show abstract

“…1,2 Early diagnosis and treatment are important in order to reduce morbidity and mortality due to the possible development of infectious complications. 9 The methods of diagnosis and treatment are standard in many centers, although preference varies among clinicians. Echocardiography may be useful in diagnosing a vascular ring in infants and children but, in particular cases, this may fail to detect the specific lesion.…”

Section: Discussionmentioning

confidence: 99%

Left-sided aortic arch, right-sided descending aorta, and right-sided arterial duct associated with interruption of the aortic arch and presence of Abbott’s artery

2007

View full text Add to dashboard Cite

We describe a male infant, seen at the age of 10 days, with a very rare form of vascular ring. The aortic arch was left-sided, but the aorta descended on the right, with a right-sided persistently patent arterial duct associated with interruption of the aortic arch and presence of Abbott's artery. We performed end-to-side anastomosis of the descending aorta to the ascending aorta, divided the Abbott's artery and the right-sided arterial duct, and banded the pulmonary trunk. Despite our best efforts, the patient died on the eighth day after the surgical intervention.

show abstract

“…It is important to stress that more than nine-tenths of all lesions producing vascular compression may be corrected through a left thoracotomy. [6][7][8][9] As intraoperative dissection and identification of all structures represents the ultimate diagnostic confirmation, 10 only certainty in the incisional approach is the one absolute preoperative must. Precise anatomic delineation with invasive or expensive procedures may be desirable for some surgeons, but are truly necessary only in the very rare cases requiring a right thoracotomy, or when the diagnosis is altogether still in doubt.…”

Section: Symptoms and Diagnostic Work-upmentioning

confidence: 99%

“…10 The chest X-ray may give the first clue to the diagnosis of extrinsic airway compression, and eventually to the type of vascular anomaly. 9,11 Indentation upon the trachea is visible on a plain or high voltage chest X-ray (Figs 1 and 2). Atelectasis or hyperinflation of various dependent lung lobes should hint at an abnormal vascular pattern.…”

Section: Symptoms and Diagnostic Work-upmentioning

confidence: 99%

“…A double aortic arch should be suspected if the side of the arch is indeterminate, being hidden in the middle of the X-ray, overlapped by the various mediastinal structures and the spine. 6 A barium swallow is the single most important diagnostic procedure in the work-up, 6,7,9,11,12 and the second to perform after an X-ray. It is specific, relatively non-invasive, cost-effective, and should in itself be sufficient to proceed with surgery without further undue escalade in imagery.…”

Section: Symptoms and Diagnostic Work-upmentioning

confidence: 99%

See 1 more Smart Citation

Vascular rings and pulmonary arterial sling: from respiratory collapse to surgical cure, with emphasis on judicious imaging in the hi-tech era

et al. 2002

View full text Add to dashboard Cite

Vascularr rings, and pulmonary arterial slings, are relatively rare vascular anomalies, but are importantt lesions to recognize, since if left untreated, patients may experience life-threatening respiratoryy compromise and "near death" episodes. Surgical therapy, however, is almost alwayss curative. As most infants and children initially present with respiratory symptoms, theyy are frequently referred to and managed by pulmonologists and otorinolaryngologists beforee being presented to a surgical team. A high index of suspicion is necessary to direct thee diagnostic work-up, which may rapidly reveal the correct diagnosis, and allow for timely surgicall repair.

show abstract

Surgical management of congenital vascular rings

Cited by 76 publications

References 9 publications

Surgical treatment of double aortic arch

Surgical treatment of double aortic arch

Left-sided aortic arch, right-sided descending aorta, and right-sided arterial duct associated with interruption of the aortic arch and presence of Abbott’s artery

Vascular rings and pulmonary arterial sling: from respiratory collapse to surgical cure, with emphasis on judicious imaging in the hi-tech era

Contact Info

Product

Resources

About