Kir M, Saylam GS, Karadas U, Yilmaz N, Çakmakçi H, Uzuner N, Güzeloğlu M, Ugurlu B, Oto Ö.Pediatr Cardiol. 2012 Apr;33(4):607-17. doi: 10.1007/s00246-012-0187-x.

Abstract for Vascular rings: presentation, imaging strategies, treatment, and outcome

This study aimed to evaluate the presenting symptoms, the effectiveness of imaging methods, and the surgical treatment of vascular rings. Data for 44 patients (32 enrolled prospectively, 12 reviewed retrospectively) over a 10-year period in a tertiary referral center were analyzed. These patients comprised 25 patients with a left aortic arch and an aberrant right subclavian artery, 13 patients with a right aortic arch and a left subclavian artery originating from Kommerell’s diverticulum, 1 patient with a right aortic arch and an aberrant left subclavian artery, 3 patients with a double aortic arch, and 2 patients with a pulmonary sling. Respiratory symptoms were found in 25 patients and dysphagia in 6 patients. Atypical symptoms such as reflex apnea, cyanosis, syncope episodes, and exercise-induced wheezing were noted in five patients. Associated congenital heart defects were detected in 41% of the patients. The diagnostic yield was 95.23% for barium esophagography, 54.54% for echocardiography, and 66.66% for computed tomography. The anatomy could be correctly identified by magnetic resonance imaging (MRI) in 97.43% and by angiography in 90.5% of the patients. Of the 30 patients who underwent surgery, 80% were completely relieved of symptoms during a mean follow-up period of 25 ± 33.5 months. Vascular rings should not be overlooked in infants with atypical symptoms. The authors’ diagnostic procedure of choice is MRI because it is superior to angiography for delineating the relationship between abnormal vascular structures, trachea, and esophagus.

Uzman Dr. Nuh YILMAZ

Specialist Dr. Nuh Yılmaz, after his medical education at Ege University Faculty of Medicine, he completed his residency in Pediatrics at İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital. He completed his subspecialty training in Pediatric Cardiology at Dokuz Eylül University Faculty of Medicine. After working as a Pediatric Cardiology Specialist at Liv Hospital Vadi Istanbul Hospital and Istanbul Medical Park Bahçeşehir Hospital, he started accepting patients at İskenderun Gelişim Hospital.