Vascular rings are congenital anomalies of the aortic arch that result in compression of the tracheobronchial tree and/or esophagus, leading to respiratory and gastrointestinal symptoms. They can be classified as either complete, when both the trachea and esophagus are fully encircled by a vascular anomaly, or incomplete without full encirclement of both structures.
The different forms of vascular rings and slings, their clinical manifestations, diagnosis, and treatment are discussed here.
Beginning at the fourth week of embryogenesis, the aortic arch develops from six symmetrical paired aortic arch vessels and the paired dorsal aortae. During the next few weeks of embryogenesis, remodeling and rearrangement of these structures result in the formation of the normal left aortic arch .
- The right and left third arches persist as the right and left carotid arteries
- The left fourth arch persists as the transverse arch
- The left sixth arch persists as the ductus arteriosus
- The right and left subclavian arteries arise from the seventh intersegmental arteries along the posterior body wall and are remodeled into the final aortic arch
Abnormal development of this complex vascular remodeling process results in malformations, which lead to the different forms of vascular rings.