Vascular rings and slings: Contemporary observations

Abstract

We reviewed our recent experience with vascular rings and slings, including observations from diagnostic imaging and surgery. We analyzed data from all patients diagnosed with a vascular ring or sling between September 2015 and August 2018. Our definition of vascular rings or slings did not include a left aortic arch with an aberrant right subclavian artery, accompanied by a left ductus arteriosus or ligamentum. We identified 74 patients for analysis. Of the 74, 45 (61%) had a right aortic arch with aberrant left subclavian artery and left-sided ductus arteriosus or ligamentum, 14 (19%) had a right aortic arch with a left-sided ductus or ligamentum and a normal left subclavian artery, 11 (15%) had a double aortic arch, 2 (3%) had a pulmonary artery sling, and 2 (3%) had a left aortic arch with aberrant right subclavian artery and a right-sided ductus arteriosus or ligamentum. Of the 74 patients, 40 (54%) were born in Nevada between January 2017 and August 2018. Of these 40, 33 (83%) were diagnosed prenatally. For the period January 2017 to August 2018, there were approximately 54,000 live births in Nevada. For right aortic arch versus double aortic vascular rings, 31 had a right aortic arch vascular ring for a prevalence of 5.7 per 10,000 live births, and 6 had a double aortic arch vascular ring for a prevalence of 1.1 per 10,000 live births (p = 0.0001). Vascular rings are common congenital cardiovascular malformations, especially right aortic arch vascular rings. Further, a high percentage of vascular rings can be detected prenatally.