INTRODUCTION Congenital vascular rings （VRs） are a group of rare cardiovascular anomalies that result from abnormal embryonic development of the paired aortic arches or branching pulmonary arteries. Clinical present...INTRODUCTION Congenital vascular rings （VRs） are a group of rare cardiovascular anomalies that result from abnormal embryonic development of the paired aortic arches or branching pulmonary arteries. Clinical presentation of VR depends on its anatomy, degree, and site of compression.展开更多
Background:Double aortic arch(DAA)with distal left-sided aortic arch atresia(LAAA)can form complete vascular ring by ligamentum connection.We aimed to introduce an uncommon DAA-LAAA diagnosis and treatment by the mini...Background:Double aortic arch(DAA)with distal left-sided aortic arch atresia(LAAA)can form complete vascular ring by ligamentum connection.We aimed to introduce an uncommon DAA-LAAA diagnosis and treatment by the minimally invasive surgical technique(MIST).Methods:We retrospectively reviewed 7 cases of DAA-LAAA that were treated from January 2017 to July 2021.All infant patients underwent surgical repair by minimally invasive surgical technique.Mean follow-up was 14.43 months(range,5–21 months).Results:There were seven patients with DAA-LAAA,including six males and one female.Median age was 19.29 months(range,9.0–29.0 months).Median weight was 11.30 kg(range,9.6–13.0 kg).Three patients were found severe tracheal compression by cardiac computed tomography angiography(cCTA).Six patients with isolated DAA-LAAA were performed operations through left subaxillary minithoracotomy,and one patient with ventricular septal defect(VSD)was performed operation concurrently under the cardiopulmonary bypass(CPB)through right subaxillary minithoracotomy.All patients had symptom improvement in the postoperative period and discharged successfully.Follow-up data showed good results in short-term.Conclusions:We introduce a new surgical pathway for DAA-LAAA treatment with good symptomatic relief in short-term.MIST is a safe,feasible and economical approach for infant patients.展开更多
Background Vascular rings are uncommon anomalies in which preferred strategies for diagnosis and management may vary among institutions. In this study, we reported our approach and a review of our 5-year experience. M...Background Vascular rings are uncommon anomalies in which preferred strategies for diagnosis and management may vary among institutions. In this study, we reported our approach and a review of our 5-year experience. Methods From May 2006 to April 2011, 45 children （31 boys） with vascular rings underwent surgical repair at Beijing Children＇s Hospital. Nineteen patients （26%） had associated heart anomalies. Results There were two hospital deaths. At follow-up, 11 patients still had intermittent respiratory symptoms, but these symptoms had no effect on growth or physical activities. No patients required reoperation. Conclusions The rates of misdiagnosis and missed diagnosis of vascular rings are higher than those of other congenital heart diseases. A high index of clinical suspicion coupled with the use of computed tomography enables early diagnosis. Surgical repair can be performed successfully, although a number of patients will have persistent symptoms.展开更多
文摘INTRODUCTION Congenital vascular rings （VRs） are a group of rare cardiovascular anomalies that result from abnormal embryonic development of the paired aortic arches or branching pulmonary arteries. Clinical presentation of VR depends on its anatomy, degree, and site of compression.
基金This study was supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)[2020-I2M-C&T-A-009]the National Key R&D Program of China[2017YFC1308100].
文摘Background:Double aortic arch(DAA)with distal left-sided aortic arch atresia(LAAA)can form complete vascular ring by ligamentum connection.We aimed to introduce an uncommon DAA-LAAA diagnosis and treatment by the minimally invasive surgical technique(MIST).Methods:We retrospectively reviewed 7 cases of DAA-LAAA that were treated from January 2017 to July 2021.All infant patients underwent surgical repair by minimally invasive surgical technique.Mean follow-up was 14.43 months(range,5–21 months).Results:There were seven patients with DAA-LAAA,including six males and one female.Median age was 19.29 months(range,9.0–29.0 months).Median weight was 11.30 kg(range,9.6–13.0 kg).Three patients were found severe tracheal compression by cardiac computed tomography angiography(cCTA).Six patients with isolated DAA-LAAA were performed operations through left subaxillary minithoracotomy,and one patient with ventricular septal defect(VSD)was performed operation concurrently under the cardiopulmonary bypass(CPB)through right subaxillary minithoracotomy.All patients had symptom improvement in the postoperative period and discharged successfully.Follow-up data showed good results in short-term.Conclusions:We introduce a new surgical pathway for DAA-LAAA treatment with good symptomatic relief in short-term.MIST is a safe,feasible and economical approach for infant patients.
文摘Background Vascular rings are uncommon anomalies in which preferred strategies for diagnosis and management may vary among institutions. In this study, we reported our approach and a review of our 5-year experience. Methods From May 2006 to April 2011, 45 children （31 boys） with vascular rings underwent surgical repair at Beijing Children＇s Hospital. Nineteen patients （26%） had associated heart anomalies. Results There were two hospital deaths. At follow-up, 11 patients still had intermittent respiratory symptoms, but these symptoms had no effect on growth or physical activities. No patients required reoperation. Conclusions The rates of misdiagnosis and missed diagnosis of vascular rings are higher than those of other congenital heart diseases. A high index of clinical suspicion coupled with the use of computed tomography enables early diagnosis. Surgical repair can be performed successfully, although a number of patients will have persistent symptoms.
