Abstract
Aortic arch anomalies are not uncommon and are the result of embryologic derangements during development of the aortic arches and their branches [1]. Early in gestation, there are both right and left aortic arches. In a majority of people, the right normally atrophies and disappears, leading to a left aortic arch. Vascular rings occur when certain structures persist rather than involute, or involute rather than persist, resulting in encirclement and compression of the trachea and esophagus [2]. This can lead to respiratory symptoms, with an estimated 3–5% of cases of stridor in infancy being due to vascular rings. In addition to airway obstruction, gastrointestinal symptoms such as dysphagia or choking with feedings can occur, but usually less frequently and present later in life (toddler or older children), and are frequently accompanied by respiratory symptoms [3].
Long-term results of the patients operated for vascular ring spectrum are generally favorable. Most infants experience significant improvement in respiratory status immediately after relief of compression caused by vascular ring. However, complete resolution of the symptoms may take a few weeks to months with gradual resolution of tracheobronchomalacia. Nonetheless, 92–95% of infants are expected to be free of their respiratory symptoms by the end of first postoperative year [4].
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Gardner, M.M., Domnina, Y.A., Morell, V.O. (2020). Vascular Rings and Pulmonary Sling. In: Munoz, R., Morell, V., da Cruz, E., Vetterly, C., da Silva, J. (eds) Critical Care of Children with Heart Disease . Springer, Cham. https://doi.org/10.1007/978-3-030-21870-6_39
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