Contemporary Approach to Vascular Rings

Area of Science:

• Pediatric Surgery
• Congenital Heart Disease
• Thoracic Surgery

Background:

• Vascular rings are rare congenital anomalies causing airway or esophageal compression.
• Improved imaging has increased diagnosis rates, but surgical outcomes need further reporting.
• This study evaluates surgical repair outcomes for vascular rings over seven years.

Purpose of the Study:

• To review early and midterm surgical outcomes of vascular ring repairs.
• To examine the impact of diagnosis timing on patient outcomes.
• To assess the safety and efficacy of contemporary surgical techniques.

Main Methods:

• Retrospective review of pediatric patients undergoing vascular ring repair (2018-2025).
• Data collected on demographics, diagnosis, surgical techniques, and complications.
• Survival analysis used for reoperation-free intervals.

Main Results:

• 77 patients underwent 78 repairs, most commonly for right aortic arch with left ligamentum (51%) or double aortic arch (44%).
• Prenatal diagnosis (73%) led to significantly earlier surgery (9.1 vs. 32.6 months).
• Low complication rates observed: 0% mortality, 7.7% chylothorax, 5.1% reoperation; 3-year freedom from reoperation was 98.3%.

Conclusions:

• Contemporary vascular ring repair is safe and effective, even in young, prenatally diagnosed infants.
• Early surgical intervention, especially for right aortic arch with left ligamentum, yields favorable outcomes.
• This study supports timely surgical management for improved patient results.