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Related Experiment Videos

Trends in vascular ring surgery.

Carl L Backer1, Constantine Mavroudis, Cynthia K Rigsby

  • 1Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA. cbacker@childrensmemorial.org

The Journal of Thoracic and Cardiovascular Surgery
|June 9, 2005
PubMed
Summary
This summary is machine-generated.

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Vascular ring diagnosis has shifted to CT/MRI, with surgical outcomes improving due to minimally invasive techniques. Recommendations include preoperative bronchoscopy and echocardiography for better patient care.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Diagnostic Imaging

Background:

  • Vascular rings are congenital anomalies affecting the aorta and pulmonary arteries.
  • Anatomically complete vascular rings include double aortic arch and right aortic arch with left ligamentum.
  • Surgical repair is necessary for symptomatic patients.

Purpose of the Study:

  • To review experience with infants and children with anatomically complete vascular rings.
  • To define perioperative trends in diagnostic imaging, operative techniques, and clinical outcomes.
  • To evaluate changes in management and outcomes over time.

Main Methods:

  • Retrospective review of 209 patients (1946-2003) with double aortic arch or right aortic arch.
  • Analysis of diagnostic imaging modalities, surgical approaches, and patient outcomes.

Related Experiment Videos

  • Comparison of trends in diagnosis and treatment over different time periods.

    • Main Results:

    • No operative mortality since 1959.
    • Shift in diagnostic imaging from barium swallow/angiography to CT/MRI.
    • Decreased mean hospital stay from 8 to 3 days with muscle-sparing thoracotomy.
    • Increased use of preoperative/intraoperative bronchoscopy (73% in the last 10 years).
    • Successful resection of Kommerell diverticulum with left subclavian artery transfer in 7 recent patients.

    Conclusions:

    • Computed tomographic scanning is the preferred diagnostic tool for vascular rings.
    • Preoperative bronchoscopy and echocardiography are recommended.
    • Muscle-sparing thoracotomy without routine chest drainage reduces hospital stay.
    • Diverticulum resection with left subclavian artery transfer is effective for right aortic arch with Kommerell diverticulum.