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

Abstract

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.

Multidetector Computed Tomography for Congenital Anomalies of the Aortic Arch: Vascular Rings

“…The symptoms of esophageal compression consist of alterations in the swallowing of solids or liquids and are more frequent in older patients, whereas respiratory symptoms are predominant in infants. [9][10][11] The techniques traditionally used for the diagnosis of these anomalies have been esophagography, echocardiography, and angiography. Tracheoesophageal compression is both from left to right and anterior to posterior for a DAA, whereas it is fundamentally posterior if there is an aberrant left or right subclavian artery.…”

“…Anterior esophageal compression is characteristic of pulmonary artery slings because the left pulmonary artery passes between the trachea and esophagus. [9][10][11] Although echocardiography is systematically performed, it is not the most useful technique because of its high false-negative rate, particularly for an aberrant left or right subclavian artery. The typical arrangement of the large vessels in a RAA mirrors that of the left aortic arch, so that the first vessel is the left brachiocephalic trunk.…”

Persistan Wheezingin Nadir Bir Nedeni: Pulmoner Arter Sling

“…PAS'de akciğer radyografisinde trakeada sola çekilme, sağ ana bronşa bası sonucu sağ akciğerde havalanma artışı ve çok ağır bası-nın olduğu olgularda tek bir lob veya bir akciğerde atelektazi görülebilir (7,10,14).…”

Multidetector computed tomography and 3-dimensional imaging: preoperative evaluation of thoracic vascular and tracheobronchial anomalies and abnormalities in pediatric patients

“…Postoperative complications, including restenosis, dissection, and pseudoaneurysm formation, can all be evaluated with MDCT and 3D imaging (Fig. 4) [24][25][26][27]. Affected infants and children may present with respiratory and/or feeding difficulties.…”

“…Affected infants and children may present with respiratory and/or feeding difficulties. Early and accurate diagnosis will facilitate their management [24][25][26][27]. Although MRI can provide information regarding underlying vascular anomalies, the evaluation of central airways and the lung parenchyma is markedly limited with MRI.…”