Issa Hejazi.
Vascular ring and sling, diagnosis and management.
Pak J Med Health Sci Jan ;5(2):355-60.

Setting: Queen Alia Heart Institute-Amman -Jordan Aim: The aim of the study is to present our experience in the diagnosis and the management of various kinds of vascular ring encountered in our institution over a ten year period. Patients and methods: A total of 21 children operated between 2000 and 2010 with complete vascular ring were identified. Their medical charts were reviewed. Data regarding clinical presentation, age at diagnosis, anatomy, investigations, surgical interventions and postoperative outcome were evaluated. Results: There were13 boys and 8 girls. The patients ranged in age from two months to one year and averaged five months. The severity of compression determines the severity of symptoms. 95.0% of patients have persistent respiratory difficulty, with only one patient presented with recurrent vomiting, and mild respiratory difficulty. Of the 21children: 12 had double aortic arches ,7.0 had a right aortic arch with left ligament arteriosum or small patent ductus arteriosus,and 2 had a pulmonary sling ( the left pulmonary artery arising from the right pulmonary artery) . Conclusion: The airways of the infant may be compressed by a variety of vascular anomalies.When a vascular ring is suspected from history and physical examination, routine chest radiograph and barium swallow can be performed with a high yield for the presence of a ring. CT angiography is a preferable modality of diagnosis for vascular ring and sling, as an alternative to conventional angiography. All vascular rings that cause symptoms should be surgically corrected.

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