Abstract：Objective To summarize the anatomical variations and surgical experiences of congenital vascular rings.Methods From Mar. 2009 to Feb. 2012, 21 patients (10 males, 11 females) between the ages of 4 months and 3 years (mean: 1.1 years) with congenital vascular rings who received surgical treatment in our department were reviewed. Anatomical variations included double aortic arch (8 cases), right aortic arch with left ligamentum arteriosum (6 cases), right aortic arch with left subclavian artery (2 cases), pulmonary sling (4 cases), left aortic arch with right ligamentum arteriosum (1 case). Associated anomalies included 4 tetralogy of Fallot, 2 ventricular septal defect, 1 single atrium, 1 total anomalous pulmonary venous connection, 1 pulmonary vein stenosis. Twelve cases were performed with the assistance of cardiopulmonary bypass through median sternotomy. Nine cases were performed without cardiopulmonary bypass (7 left thoracic incisions, 2 left subaxillary incisions).Results All the patients recovered uneventfully and discharged from hospital after recovery. Follow-up (mean 3.6 years) information showed that the patients had normal growth and development and the respiratory symptoms were relieved.Conclusions Surgical treatment of congenital vascular rings should be performed as soon as possible according to the anatomical variations and associated anomalies of the heart. Excellent clinical results can be achieved after surgery.
武开宏,莫绪明,孙剑,彭卫,戚继荣,钱波. 先天血管环畸形的解剖变异及外科治疗[J]. 中华解剖与临床杂志, 2014, 19(3): 177-179.
Wu Kaihong, Mo Xuming, Sun Jian, Pen Wei, Qi Jirong, Qian bo. The anatomical variations and surgical treatment of congenital vascular rings. Chinese Journal of Anatomy and Clinics, 2014, 19(3): 177-179.
Russell HM, Backer CL. Pediatric thoracic problems: patent ductus arteriosus, vascular rings, congenital tracheal stenosis, and pectus deformities[J]. Surg Clin North Am, 2010, 90(5): 1091-1113.
[2]
Robson EA, Scott A, Chetcuti P, et al. Vascular ring diagnosis following respiratory arrest[J]. BMJ Case Rep, 2014. 2014, pii: bcr 2013 02164.
[3]
Yang M, Mo XM, Jin JY, et al. Image quality and radiation exposure in pediatric cardiovascular CT angiography from different injection sites[J]. AJR Am J Roentgenol, 2011, 196(2): W117-W122.
[4]
Bai S, Li XF, Liu CX, et al. Surgical treatment for vascular anomalies and tracheoesophageal compression[J]. Chin Med J (Engl), 2012, 125(8): 1504-1507.
[5]
Chiu PP, Rusan M, Williams WG, et al. Long-term outcomes of clinically significant vascular rings associated with congenital tracheal stenosis[J]. J Pediatr Surg, 2006, 41(2): 335-341.
[6]
Núez-Gil IJ, García-Guereta L, Bret-Zurita M. Real vision of a vascular ring[J]. Eur Heart J Cardiovasc Imaging, 2012, 13(3): 279.
Ullmann N, Menchini L, Salerno T, et al. Late diagnosis of double aortic arch: consequences on long-term follow-up[J]. Pediatr Pulmonol, 2014, 49(3): E75-E77.
[11]
Samas J, Manetta F, Meyer DB. Repair of vascular ring with resection of kommerell diverticulum and transposition of aberrant left subclavian artery[J]. Int J Angiol, 2013, 22(4): 243-244.
[12]
Joshi A, Agarwal S, Aggarwal SK, et al. Single stage repair of tetralogy of fallot associated with left pulmonary artery sling and tracheal stenosis[J]. J Card Surg, 2013, 28(5): 595-598.
