Clinical Course of Vascular Rings and Risk Factors Associated With Mortality.
10.4070/kcj.2012.42.4.252
- Author:
Yoon Jung SUH
1
;
Gi Beom KIM
;
Bo Sang KWON
;
Eun Jung BAE
;
Chung Il NOH
;
Hong Gook LIM
;
Woong Han KIM
;
Jeong Ryul LEE
;
Yong Jin KIM
Author Information
1. Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea. ped9526@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Vascular rings;
Congenital heart disease;
Pulmonary artery sling;
Clinical characteristics;
Mortality
- MeSH:
Aneurysm;
Aorta, Thoracic;
Arteries;
Cardiovascular Abnormalities;
Deglutition Disorders;
Early Diagnosis;
Heart Diseases;
Humans;
Magnetic Resonance Imaging;
Prognosis;
Pulmonary Artery;
Retrospective Studies;
Risk Factors;
Subclavian Artery;
Tracheal Stenosis
- From:Korean Circulation Journal
2012;42(4):252-258
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Vascular rings refer to anomalies of the great arteries that cause respiratory or feeding problems. The purpose of this study was to analyze a series of patients with vascular rings and evaluate associated risk factors for mortality. SUBJECTS AND METHODS: A retrospective review of all patients identified with vascular rings between 1997 and 2010 in the Seoul National University Children's Hospital. RESULTS: Thirty-five patients were diagnosed with vascular rings (median age at diagnosis, 7 months). The vascular rings of 32 patients were confirmed by cardiac computed tomography or magnetic resonance imaging. The types of vascular rings were: a double aortic arch in ten patients, a right aortic arch with persistent left ligamentum arteriosum in seven, an aberrant subclavian artery in seven, a pulmonary sling in eight, and others types in three patients. Eleven patients were asymptomatic. Gastrointestinal and respiratory symptoms were seen in ten and sixteen patients, respectively. Associated cardiovascular anomalies were present in fifteen patients. Twenty patients with definite symptoms underwent surgical treatment. The median interval between diagnosis and operation was 6 days. Four patients eventually died; three deaths were associated with complex heart diseases, and one had pulmonary artery sling with severe tracheal stenosis. Only the presence of a complex heart disease significantly influenced mortality (p=0.002). CONCLUSION: Vascular rings include several types of anomalies, each with a different prognosis and symptoms. The presence of a complex heart disease was significantly associated with mortality. Early diagnosis and timely surgery in symptomatic patients are essential.
