The prevalence, clinical profile and surgical outcomes of children presenting with vascular ring and pulmonary sling

Main Article Content

Chinawa JM*
Agarwal V
Garekar S
Gaikwad S
Trivedi B

Abstract

Background: Vascular anomalies are rare abnormalities which present with inspiratory stridor and recurrent respiratory tract infection. They are the commonest causes of mortality and morbidity in children due to misdiagnosis. They comprise about less than 4% of congenital heart diseases. The commonest of these anomalies were vascular ring and pulmonary sling.


Objectives: The objective of this study was to determine the prevalence, pattern of presentation and surgical outcomes of children presenting with vascular ring and pulmonary sling.


Methods: A cross-sectional retrospective study in which a review of the records of all children attending Fortis hospital over a 3-year period (2012- and 2015) was undertaken.


Data were analyzed using SPSS 20. Frequencies, rates and proportions were represented in tables. Children with confirmed diagnosis of vascular rings and pulmonary slings are included while other causes of stridor were excluded from this study.


Result: A total of 1200 children had open heart surgery in the hospital over a three-year period. Of these, 2 had vascular ring and 3 had pulmonary sling giving a prevalence of 0.4%. Out of the 5 cases, 3 (60 %) were male and 2 (40%) female. Male to female ratio was 1.5:1. The mean age of presentation was 2.46± 3.52 months. There were three neonates and two infants. All presented with stridor. The mean number of days spent postoperatively was 8±3 days and tracheal stenosis was the only complication noted.


Computerized axial tomography (CT) scan of one of the subjects with vascular ring showed a dilated Kommerells diverticulum (KD).


Conclusion: Vascular ring and pulmonary sling are rare congenital abnormalities seen in our center, early identification and repair will help avert numerous complications that follow it.

Downloads

Download data is not yet available.

Article Details

JM, C., V, A., S, G., S, G., & B, T. (2018). The prevalence, clinical profile and surgical outcomes of children presenting with vascular ring and pulmonary sling. Journal of Cardiovascular Medicine and Cardiology, 5(4), 067–072. https://doi.org/10.17352/2455-2976.000075
Research Articles

Copyright (c) 2018 Chinawa JM, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.

We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.

Peertechz accomplice with- [CC BY 4.0]

Explanation

'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.

Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.

With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:

License Name

Permission to read and download

Permission to display in a repository

Permission to translate

Commercial uses of manuscript

CC BY 4.0

Yes

Yes

Yes

Yes

The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.

Jai PS, Mohan M, Suresh K, Kirti C, Pradeep S, et al. (2017) Journal of evidenced based medicine and Healthcare 4: 1568-1571.

Humphrey C, Duncan K, Fletcher S (2006) Decade of experience with vascular rings at a single institution. Pediatrics 117: 903-908. Link: https://goo.gl/aAgQJo

Greiner A, Perkmann R, Rieger M, Neuhauser B, Fraedrich G (2003) Vascular ring causing tracheal compression in an adult patient. Ann Thorac Surg. 75: 1959-1960. Link: https://goo.gl/hDpoQP

Sade RM, Rosenthal A, Fellows K (1975) Pulmonary artery sling. J Thorac Cardiovasc Surg 69: 333-346.

Newman B, Cho YA (2010) Left Pulmonary Artery Sling-Anatomy and Imaging. Semin Ultrasound CT MR 31: 158-170. Link: https://goo.gl/aZYMbz

Stem bronchus.JAMA (1998) 1954. 155:1409.pulmonary slings: the role of MRI. Magnetic Resonance Imaging 16:137-45.

Backer CL, Russell HM, Kaushal S, Rastatter JC (2012) Pulmonary artery sling: Current results with cardiopulmonary bypass. J Thorac Cardiovasc Surg 143:144-151. Link: https://goo.gl/nGcYec

Morrow R, Huhta J (1990) Aortic arch and pulmonary artery anomalies. The Science and Practice of Pediatric Cardiology 1: 1444-1447.

Bai S, Li XF, Liu CX (2012) Surgical treatment for vascular anomalies and tracheoesophageal compression.Chin Med J (Engl) 125: 1504-1507. Link: https://goo.gl/UGGBzT

Axt-Fliedner R, Kawecki A, Enzensberger C, Wienhard J (2011) Fetal and Neonatal Diagnosis of Interrupted Aortic Arch: Associations and Outcomes. Fetal Diagn Ther 30: 299–305. Link: https://goo.gl/Ng1Eia

Newman B, Cho YA (2010) Left Pulmonary Artery Sling-Anatomy and Imaging. Semin Ultrasound CT MR 31: 158-170. Link: https://goo.gl/d5dnnA

Backer CL, Russell HM, Kaushal S, Rastatter JC, Rigsby CK, et al. (2012) Pulmonary artery sling: Current results with cardiopulmonary bypass. J Thorac Cardiovasc Surg 143: 144-151. Link: https://goo.gl/XFFch3

Turner A, Gavel G, Coutts J (2005) Vascular rings--presentation, investigation and outcome. Eur J Pediatr 164: 266-70. Link: https://goo.gl/XJxygq

Humphrey C, Duncan K, Fletcher S (2006) Decade of experience with vascular rings at a single institution.Pediatrics 117: 903-908. Link: https://goo.gl/D75dx3

Fiore AC, John WB, Thomas R (2003) Weber, Mark WTurrentine. Surgical Treatment of Pulmonary Artery Sling and Tracheal Stenosis .Presented at the Fiftieth Annual Meeting of the Southern Thoracic Surgical Association, Bonita Springs, FL, 13–15. Link: https://goo.gl/3cBWB6

Loukanov T, Sebening C, Springer W (2005) Simultaneous management of congenital tracheal stenosis and cardiac anomalies in infants. J Thorac Cardiovasc Surg 130: 1537-1544. Link: https://goo.gl/qfXPb1

Suh YJ, Kim GB, Kwon BS, Bae EJ, Noh CI, et al. (2012) Clinical Course of Vascular Rings and Risk Factors Associated With Mortality. Korean Circ J 42: 252–258. Link: https://goo.gl/uCBXQj

Michał P, Łukasz C, Jarosław DK, Ludomir S, Mirosław T (2014) “The Aberrant Right Subclavian Artery (Arteria Lusoria): The Morphological and Clinical Aspects of One of the Most Important Variations—A Systematic Study of 141 Reports,” The Scientific World Journal. Link: https://goo.gl/3vMh5k

Ronny C, Pablo L, Christine G, Lizmer D, Brooks M (2012) Syncope as Initial Presentation of Kommerell Diverticulum. Int J Angiol 21: 111–116. Link: https://goo.gl/QFLqfp

Yong MS, D'Udekem Y, Robertson CF, Butt W, Brizard CP, et al. (2014) Konstantinov IE. Tracheal repair in children: reduction of mortality with advent of slide tracheoplasty. ANZ J Surg 84: 748-754. Link: https://goo.gl/uXnhwm

Lee JH, Yang JH, Jun TG (2015) Video-assisted thoracoscopic division of vascular rings. Korean J Thorac Cardiovasc Surg 48: 78-81. Link: https://goo.gl/pGw3bC

Weber TR, Keller MS, Fiore A (2002) Aortic suspension (aortopexy) for severe tracheomalacia in infants and children. Am J Surg 184: 573–577. Link: https://goo.gl/1GDxew

Fiore AC, Brown JW, Weber TR, Turrentine MW (2005) Surgical treatment of pulmonary artery sling and tracheal stenosis. Ann Thorac Surg 79: 38-46. Link: https://goo.gl/eV7xwg