Introduction: Vascular ring malformations pose a significant, but surgically correctable, problem in pediatric cardiothoracic patients. Current studies fail to reach a consensus regarding the optimal means of diagnosis and surgical outcomes of these anomalies. Furthermore, these studies have massive variability in reported post-operative outcomes.
Methods: A retrospective review of 27 patients treated for vascular rings between 1999 and 2007 analyzed surgical outcomes with respect to age, weight, and type of vascular ring. Analysis provided an overview of presenting statistics of these malformations and correlated age of treatment, weight, and type of vascular ring with length of stay (LOS), length of post-operative ventilation (LOV), and surgical morbidity. Additionally, this study compared the rate of successful anomaly prediction by various diagnostic modalities.
Results: Data indicated that age < 90 days at time of treatment, weight < 6 kg at the time of treatment, and double aortic arch variant (DAA) were all factors predictive of increased LOVand LOS. CT and MRI were able to diagnose the specific type of malformation in >94% of cases. Echocardiography and barium esophagraphy provided low sensitivity and specificity at detecting malformations. Finally, age of < 90 days and DAA were predictive of increased post-operative tracheomalacia.
Conclusions: Age, weight, and specific malformation influence LOS, LOV, and cost of procedure. Specific symptoms were predictive of malformation type. DAA malformations have significantly increased rates of post-operative tracheomalacia. CT or MRI appear to be more effective means of diagnosis of vascular rings, while barium esophagraphy is a more appropriate screening modality.