Vascular Rings, Tracheoplasty, and Pulmonary Artery Sling

Abstract

The phrase “vascular ring” refers to a group of vascular anomalies that result from abnormal development of the aortic arch system and cause compression of the trachea, the esophagus, or both. The vascular rings that form a true, complete ring and encircle both the esophagus and trachea are the double aortic arch and the right aortic arch with left ligamentum arteriosum. Partial vascular rings include innominate artery compression syndrome, pulmonary artery sling, and left aortic arch with aberrant right subclavian artery. Patients with these anomalies also present with symptoms from esophageal and tracheal compression. Nearly two thirds of those with a pulmonary artery sling have what is known as the “ring/sling complex”—the combination of pulmonary artery sling and complete tracheal rings—so the surgeon must be prepared to repair the trachea at the time of pulmonary artery sling surgery.