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Vascular Ring: Results of the surgical management
Vascular Ring: Results of the surgical management
Barbaros KINOĞLU, Tayyar SARIOĞLU, Levent SALTIK, Ahmet ÖZKARA, Ayşe SARIOĞLU, M. Salih BİLAL, Özge KÖNER, Rüstem OLGA, Aydın AYTAÇ
İ. Ü. Kariyoloji Enstitüsü Kalp Damar Cerrahisi Anabilim Dalı, Pediatrik Kardiyoloji Bilim Dalı
Vascular ring is an anomaly which occurs as a result of the anomalous development of the aortic arch complex and is mostly encountered in the infantile period with tracheoesophageal compression symptoms. Between 1988 and 1996, 11 patients who underwent surgical correction of vascular ring in our institute, have been reviewed according to the morphology, symptomatology, and the surgical technique applied with respect to long-term results. The patients whose ages vary from 8 months to 20 years, were studied in three groups according to morphology. Tracheoesophageal compression symptoms and frequent respiratory tract infections were the major symptoms in 6 patients with double aortic arch (group 1) and in 2 patiens with right aortic arch, aberrant left subclavian artery and ligamentum arteriosum (group 2). Among 3 patients in whom partial vascular ring formed by left aortic arch and aberrant right subclavian artery were identified (group 3), the 2 patients who also had coarctation of the aorta were asymptomatic while the other patient had disphagia, vomiting and coughing provoked by eating. Surgical correction was successfully performed throught left posterolateral thoracotomy in all of the patiens. The patiens were followed up in an average period of 47.5±35.3 months. Balloon dilation was performed to a patient in whom the oesophegeal stricture persisted after the repair. All other patients were found to be asymptomatic in their long term follow-up. Vascular ring is a pathology which should always be considered when respiratory and eating difficulties are encountered in the neonates and infants. Today, complete recovery is possible with early diagnosis and treatment, since surgical mortality is approximately zero in this anomaly.
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