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Vertical vascular ring around right mainstem bronchus.

Noëlla Bethuyne¹, Marijke Proesmans, Wim Daenen

¹Department of Cardiac Surgery, University Hospital Gasthuisberg, Leuven, Belgium. noella.bethuyne@pi.be

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery

|March 3, 2007

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An 18-year-old male presented with an unusual vascular ring causing right lung issues. Surgical and bronchoscopic treatment successfully relieved the compression on his airway.

Area of Science:

Cardiology
Thoracic Surgery
Pediatric Cardiology

Background:

Vascular rings are congenital anomalies of the aortic arch and its branches.
Atypical presentations can pose diagnostic challenges, particularly when associated with other congenital abnormalities.

Observation:

An 18-year-old male presented with symptoms suggestive of right lung pathology.
Imaging revealed a complex vascular ring involving a right aortic arch, right descending aorta, persistent right ligamentum arteriosum, and dilated right pulmonary artery.
Discontinuous pulmonary arteries and a single functional right lung were noted concurrently.

Findings:

The right mainstem bronchus was compressed between the descending aorta and the dilated right pulmonary artery.
Surgical exploration confirmed a vertical vascular ring completed by the right-sided ligamentum arteriosum passing under the right mainstem bronchus.

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Implications:

This case highlights a rare and complex vascular ring anomaly.
Successful surgical and bronchoscopic intervention demonstrates effective management strategies.
Understanding these complex anatomical variations is crucial for accurate diagnosis and treatment in pediatric and adult cardiovascular care.