by Neff DM

Vascular Ring—Child

Definition

A vascular ring is a defect of the aorta and nearby large vessels. The aorta is the large artery that carries blood from the heart to the body. When the aorta and nearby large vessels form in abnormal positions, the trachea and esophagus can become constricted by the “ring” formed by these abnormal vessels. Examples of this type of defect include:
  • Double aortic arch
  • Right aortic arch
While vascular ring may be detected in infancy, it is often discovered later in life.
Heart and Main Vessels
BP00015 96472 1 aorta.jpg
Copyright © Nucleus Medical Media, Inc.

Causes

Vascular ring is a congenital defect. This means that the baby is born with the condition. During fetal growth in the womb, the large vessels near the heart do not develop normally. It is not known exactly why some children’s vessels develop in this way.

Risk Factors

Specific risk factors for vascular ring are not known.

Symptoms

Symptoms vary and can range from mild to severe. They may include:
  • Trouble breathing (wheezing, coughing, noisy breathing)
  • Lung infections
  • Poor feeding of solid food (eg, vomiting or choking)
  • Trouble swallowing
  • Acid reflux
These symptoms may be caused by other conditions. If your child has any of these, tell the doctor right away.

Diagnosis

Your doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests may include:
  • Echocardiogram —an imaging test that uses sound waves to look at the size, shape, and motion of the heart
  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the chest
  • MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
  • Chest x-ray —an imaging test that uses low amounts of radiation to create an image of the chest
  • Electrocardiogram —a test that measures the electrical activity of the heart
  • Upper gastrointestinal series —a series of x-rays of the esophagus, stomach, and duodenum (the first part of the small intestine)
  • Bronchoscopy —a visual exam of the air passages leading into the lungs

Treatment

Talk with your doctor about the best treatment plan for your child. Treatment options include:

Surgery

The goal of surgery is to divide the vascular ring and relieve compression on the trachea and esophagus. This surgery may even be done if your child has minor symptoms.

Other Treatments

Before surgery, the doctor will treat your child’s symptoms. For example, the doctor will make sure that your child gets proper nutrition if he has swallowing problems. If your child has a bacterial respiratory infection, he will be treated with antibiotics.

Lifelong Monitoring

Your child will have regular exams from a heart specialist.

Prevention

There is no way to prevent formation of a vascular ring. Getting appropriate prenatal care is always important.

RESOURCES

American Family Physician http://www.aafp.org/

American Heart Association http://www.americanheart.org/

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca/

Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/splash/

References

Children’s Hospital Boston. Vascular ring. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1942/mainpageS1942P0.html. Accessed July 23, 2010.

Cincinnati Children’s Hospital. Vascular rings. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/heart-encyclopedia/anomalies/rings.htm. Accessed July 23, 2010.

Johns Hopkins University, Cove Point Foundation. Vascular ring. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=vascularring2. Accessed July 9, 2010.

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