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Vascular Rings 56.15

Vascular Rings 56.15. Amoreena Howell. 2 day old F Dyspnea and cough, inspiratory stridor Worse with feeding. MRA. MRA. click on image. Vascular Rings. Complete vs. Partial Double Aortic arch most common (40%) failure of regression of both the right and left fourth branchial arches

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Vascular Rings 56.15

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  1. Vascular Rings 56.15 Amoreena Howell

  2. 2 day old F Dyspnea and cough, inspiratory stridor Worse with feeding

  3. MRA

  4. MRA click on image

  5. Vascular Rings Complete vs. Partial • Double Aortic arch most common (40%) • failure of regression of both the right and left fourth branchial arches • Right aortic arch with left ligamentum arteriosum • highly associated with congenital heart defects (98% of cases), particularly TOF • Anomalous left PA (vascular sling) • rare, the left PA arises from the right PA Barium Esophogram reveals indentations MRI for complete anatomy

  6. Aortic Development

  7. Mangement • Medical if asymptomatic (careful feeding, soft foods, aggressive tx of pulm infections) • Surgical division of ring if symptomatic

  8. References Myung K. Park, Pediatric Cardiology for Practitioners, 4th ed., St. Louis, Mosby Inc., 2002, pp. 241-246. Townsend CM, Beauchamp ED, Evers BM, Mattox KL, Sabiston Textbook of Surgery, 17th ed., Philadephia, Elsevier, 2004, p. 1837 Collins-Nakai R, “How congenital heart disease originates in fetal life.” Cardiol Clin, 01-AUG-2002; 20(3): 367-83, v-vi

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