| Vascular ring | |
|---|---|
| Specialty | Vascular system |
Avascular ring is a congenital defect in which there is an abnormal formation of theaorta and/or its surroundingblood vessels. Thetrachea andesophagus are completely encircled and sometimes compressed by a "ring" formed by these vessels, which can lead to breathing and digestive difficulties.[1][2]
Most often this is because of persistence of thedouble aortic arch after the second month of fetal life.[citation needed]
The two arches surround the esophagus and trachea which, if sufficiently constrictive, may cause breathing or swallowing difficulties despite medical therapies.[citation needed]
A less common ring is present with a right aortic arch instead of the usual left-sided aortic arch. This compresses the esophagus and trachea because of the persistence of a ductal ligament (fromfetal circulation) that may connect between the aorta on the front and theleft subclavian artery posteriorly going to the left arm.[citation needed]
Infants with vascular rings typically present before 12 months with respiratory or esophageal symptoms like stridor, wheezing, cough, dysphagia, or difficulty feeding. The stridor improves with neck extension, differentiating fromlaryngomalacia which is relieved by prone or upright positioning, and will not be relieved with corticosteroids or epinephrine, unlikecroup. Diagnosis requires a high degree of clinical suspicion and can be confirmed with barium contrast esophagogram for those with esophageal symptoms, bronchoscopy, or CT or MRI.[3]
It is sometimes treated with surgery.[4]