Background
Adults with potentially life-threatening congenital vascular anomalies due to tracheoesophageal compression and aneurismal rupture are often misdiagnosed as having asthma or recurrent bronchopulmonary infection. However, the early recognition and treatment of these anomalies can help to achieve a low mortality rate.

Methods
Two-dimensional echocardiography(2DE) was used to diagnose anatomically complete vascular rings(including double aortic arch and right aortic arch with left ligamentum arteriosum) in 96 patients. They underwent a barium esophagogram, spiral CT and/or MRI to confirm the existence of the vascular rings. Demographics, historical objectives and the results of physical examinations were all taken into account when performing the clinical diagnosis, as opposed to the conventional methods that are used when diagnosing ACVR. Those patients with overt clinical symptoms of tracheoesophageal compression were then earmarked for surgical treatment.

Results
Among the patients diagnosed with ACVR, 64 received surgical treatment after ACVR was confirmed. Right aortic arch(RAA) with Kommerell’s divertiuculum(KD) with left ligamentum arteriosum was found to be the most common type of ACVR(80.3% of cases). 2DE was found to have a 100% overall sensitivity and a 100% specificity with regard to its ability to diagnose ACVR. Recurrent bronchopulmonary infections and asthmatic cough were the dominant symptoms of tracheal compression and all of these patients who underwent surgical treatment were well without morbidity and mortality.

Conclusion
2DE is an effective primary diagnostic method with a high sensitivity and specificity. Early surgical management of ACVR is safe and easily achieved.