C. P. Callahan1, T. Merritt1, H. Jalal1, S. Lange1, M. Canter1, P. Eghtesady1, P. Manning1, A. Abarbanell1 1Washington University,Pediatric Cardiothoracic Surgery,St. Louis, MO, USA
Introduction: Vascular ring is often diagnosed after extensive evaluation for swallowing and breathing difficulties. There is a paucity of data regarding the long-term status of symptoms following vascular ring repair.
Methods: We retrospectively reviewed the records of 63 patients who underwent open vascular ring repair from July 2007 to May 2018. Preoperative demographics, symptoms, and confirmed chromosomal abnormalities were reviewed. Vascular anatomy was confirmed with available preoperative imaging and operative records. Post-operative data included freedom from reoperation, 30-day mortality and complications. Records were abstracted for most recent follow-up and symptom resolution.
Results: Demographic data are shown in Table 1. The median age at the time of surgical intervention was 439 days (2.4 mo. – 16.1 yrs.) for a single aortic arch with an aberrant subclavian artery and 172 days (0.2 mo. – 10.6 yrs.) for a double aortic arch. All patients were symptomatic except two single aortic arches. There was no operative mortality. Post-operatively, three patients required thoracic duct ligation. Aortopexy was required in three patients. Two patients had a cardiac arrest postoperatively due to airway malacia. At last follow-up, 42% (16/38) of single aortic arches and 64% (16/25) of double aortic arches had documented post-operative symptoms. Persistent breathing and swallowing difficulties remained in 37% (14/38) single aortic arches and 60% (15/25) double aortic arches.
Conclusion: Open vascular ring repair remains a safe intervention. Our data suggests that further investigation of long-term symptoms in these patients is merited which could impact the future standard-of-care for these patients.
