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Outcomes for Children With Vascular Ring Repair Using a Simple Surgical Approach.

C Mason Berry1, Luz A Padilla1, Robert Sorabella1

  • 1Division of Cardiothoracic Surgery, Department of Surgery, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

The Journal of Surgical Research
|July 19, 2024
PubMed
Summary

A simple surgical approach effectively treated vascular rings (VRs), significantly reducing symptoms and reintervention rates. Preoperative tracheomalacia was identified as a key risk factor for persistent symptoms post-VR repair.

Keywords:
Aortic archChildrenTracheomalaciaVascular ring

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Area of Science:

  • Congenital Cardiovascular Surgery
  • Pediatric Surgery
  • Thoracic Surgery

Background:

  • Vascular Rings (VRs) are congenital aortic arch malformations causing tracheal and esophageal compression.
  • Persistent symptoms post-VR repair affect 5-10% of patients, with 9% needing reintervention.
  • Surgical repair approaches range from simple ligation to complex procedures.

Purpose of the Study:

  • To evaluate outcomes of a "simple" surgical approach for vascular ring repair.
  • To identify risk factors for persistent symptoms after VR repair.

Main Methods:

  • Retrospective review of 93 patients undergoing VR repair (2012-2022).
  • Extraction of clinical, surgical, and demographic data from electronic medical records.
  • Analysis of intraoperative and postoperative outcomes, including regression analysis for risk factors.

Main Results:

  • Symptom prevalence decreased from 80% preoperatively to 13% postoperatively (P=0.03).
  • Tracheomalacia rates reduced from 16% to 7% post-repair.
  • No mortality was reported; reintervention was required in 2% of patients. Preoperative tracheomalacia was linked to persistent symptoms (OR 6.2).

Conclusions:

  • A simple surgical approach for VR repair demonstrates significant symptom reduction and low reintervention rates.
  • No mortality was observed in this cohort.
  • Preoperative tracheomalacia is a significant risk factor for persistent symptoms following VR repair.