Clinical characteristics and treatment of congenital vascular rings in 54 infants

Abstract

Objective To summarize the clinical characteristics and therapeutic effect of congenital vascular rings in infants. Methods The clinical data of 54 children with vascular rings were retrospectively analyzed from August 2011 to June 2017 at our center for surgical treatment. Age 2 days to 11 months, the median age was 1 months; weight 1.4-9.4 kg, the average weight of(4.52±1.89) kg. The type of vascular ring includes 21 cases of double aortic arch, right aortic arch with left aortic duct / ligament with or without vagal left subclavian artery in 14 cases, 9 cases of pulmonary artery suture, left aortic arch with right aortic duct / ligament with or without 5 cases of oblique right subclavian artery, 3 cases of nameless arterial compression syndrome, 2 cases of other vascular rings. All cases underwent echocardiography, chest radiography, and CT scan of the heart, and 42 cases were examined before operation or intraoperative bronchoscopy. 39 cases(72%) had tracheal stenosis. Results Twenty-six patients underwent extracorporeal circulation underwent vascular anteroposterior surgery with an average extracorporeal circulation time of(160±61) min and 28 patients underwent extracorporeal circulation. Postoperative mechanical ventilation 1 to 22 days, the median number of days 2 days; hospitalization time 7 to 62 days, the median of 19 days, hospital death in 2 cases(3.7%). Discharge patients were followed up for 2 to 74 months, respiratory symptoms to varying degrees to ease or disappear, discharged in 3 cases. Conclusion Airway stenosis is a serious complication of the vascular ring. CT is the best way to determine the vascular ring. To avoid serious airway complications, the vascular ring should be operated as soon as possible, and the airway stenosis and intracardiac malformation Children suggested concurrent treatment, this can improve the survival rate of surgery and improve the prognosis of children. Key words: Vascular rings; Tracheal stenosis; Double aortic arch