- Amy L Juraszek, MD, FAAP, FACC
Amy L Juraszek, MD, FAAP, FACC
- Associate Professor of Pediatrics
- UT Southwestern Medical School
- David R Fulton, MD
David R Fulton, MD
- Section Editor — Pediatric Cardiology
- Associate Professor of Pediatrics
- Harvard Medical School
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, and 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 [1,2].
●The right and left third arches persist as the right and left carotid arteries
●The left fourth arch persists as the transverse arch
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- Left aortic arch
- Right aortic arch
- Complete vascular rings
- - Double aortic arch
- - R aortic arch with aberrant L subclavian artery and L ductus arteriosus/ligamentum
- - Other causes
- Incomplete vascular rings
- CLINICAL MANIFESTATIONS
- Presenting symptoms
- Associated anomalies
- Physical examination
- Our approach
- Antenatal diagnosis
- DIFFERENTIAL DIAGNOSIS
- Complete vascular rings
- Other vascular abnormalities (or anomalies)
- Alternative surgical techniques
- Pharmacologic treatment
- SUMMARY AND RECOMMENDATIONS