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A vascular ring is an abnormality of the major blood vessels in which one or more vessels form a circle (or ring) around the trachea or bronchi (breathing tubes), or the esophagus (food tube).
Vascular rings can lead to a tightening of the airway or esophagus, making it hard to breath or swallow.
There are many types of blood vessel arrangements that cause vascular rings.
- Double aortic arch: the aorta splits into two parts, one going to the right of the trachea and one to the left of the trachea (a normal aorta goes only to the left). The two arches encircle the trachea and esophagus and often cause compression on these structures.
- Right-sided aortic arches: The right-sided aortic arch goes over the right bronchus. Depending on how the blood vessels come from the aorta and how other vessels are arranged, this can lead to compression on the esophagus or trachea or bronchus.
There is no known cause of vascular rings, thought it can be associated with DiGeorge syndrome.
Diagnosing Vascular Rings
Vascular rings can be diagnosed via:
- Echocardiogram - an ultrasound of the heart.
- Fetal echocardiogram - an ultrasound of the heart before birth
- CT scan
- Barium swallow test
Surgery for Vascular Rings
Many people with vascular rings never require treatment or surgery.
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The decision about which people need surgery depends on whether or not there are symptoms, and what type of vascular ring is found.
Most people with double aortic arch will require surgery. Only people with symptoms due to the vascular rings from a right-sided aortic arch will require surgery. Most people with a right aortic arch never need surgery.
Surgery involves cutting a blood vessel or other tissue that is pushing on the trachea or esophagus. Usually this is a simple procedure with a short recovery time.
Long-term Prognosis - Vascular Rings
The long-term prognosis is very good.
Since many people do not have symptoms, they never have to have surgery.
If surgery is necessary, this usually helps the symptoms. Babies who have breathing problems due to double aortic arch usually continue to have breathing problems for a few weeks to months after surgery because the cartilage in the trachea is still soft. With time, this gets better and long-term breathing problems are rare.