Article

Decade of experience with vascular rings at a single institution.

Department of Pediatrics, Children's Hospital, Creighton University, Omaha, NE 68114-4113, USA.
PEDIATRICS (impact factor: 4.47). 06/2006; 117(5):e903-8. DOI:10.1542/peds.2005-1674 pp.e903-8
Source: PubMed

ABSTRACT Over the past decade, the diagnostic workup of vascular rings has changed at our institution. Despite surgical intervention, we have observed long-term aerodigestive issues in some patients. In an effort to better characterize these pre- and postoperative issues, we reviewed a decade of experience at our institution.
We performed a complete chart review of all patients identified as having surgical intervention for vascular ring between January 1993 and December 2003. A questionnaire was mailed to the family of each patient to ascertain a subjective assessment of long-term postoperative issues.
Thirty-eight patients were reviewed and categorized as to specific arch anomaly. Associated cardiac anomalies were present in 29% of patients. Chronic feeding difficulties persisted in 18% of patients, and airway issues remained in nearly half of the patients. Patients with underlying genetic syndromes had less resolution of symptoms compared with nonsyndromic children. Chronic respiratory symptoms were present in 80% of patients operated <6 months, 15% if operated between 6 months and 3 years, and 42% of patients operated after 3 years of age.
Aerodigestive issues may persist after vascular ring division despite initial improvement. Accurate preoperative anatomic imaging is imperative to surgical planning.

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Keywords

<6 months
 
Accurate preoperative anatomic imaging
 
Aerodigestive issues
 
airway issues
 
Associated cardiac anomalies
 
Chronic respiratory symptoms
 
genetic syndromes
 
initial improvement
 
long-term aerodigestive issues
 
long-term postoperative issues
 
nonsyndromic children
 
Patients
 
postoperative issues
 
pre-
 
specific arch anomaly
 
surgical intervention
 
surgical planning
 
vascular ring
 
vascular ring division
 
vascular rings
 

Carrie Humphrey