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Vascular Rings
Complete vs. Partial• Double Aortic arch most common (40%)
– failure of regression of both the right and left fourth branchial arches
• Right aortic arch with left ligamentum arteriosum – highly associated with congenital heart defects (98% of
cases), particularly TOF • Anomalous left PA (vascular sling)
– rare, the left PA arises from the right PA
Barium Esophogram reveals indentationsMRI for complete anatomy
Mangement• Medical if asymptomatic (careful feeding, soft foods, aggressive
tx of pulm infections)• Surgical division of ring if symptomatic
References
Myung K. Park, Pediatric Cardiology for Practitioners, 4th ed., St. Louis, Mosby Inc., 2002, pp. 241-246.
Townsend CM, Beauchamp ED, Evers BM, Mattox KL, Sabiston Textbook of Surgery, 17th ed., Philadephia, Elsevier, 2004, p. 1837
Collins-Nakai R, “How congenital heart disease originates in fetal life.” Cardiol Clin, 01-AUG-2002; 20(3): 367-83, v-vi