VASCULAR RING DOUBLE AORTIC ARCH

Course overview

THE TERM "VASCULAR RING" REFERS TO THE VASCULAR STRUCTURES THAT ENCIRCLE AND COMPRESS THE TRACHEA AND ESOPHAGUS CAUSING RESPIRATORY AND GASTROINTESTINAL SYMPTOMS. IT CAN BE FURTHER CLASSIFIED BASED ON THE LOCATION OF THE AORTIC ARCH. AN ARCH SIDEDNESS IS DEFINED BY THE POSITION OF THE AORTIC ARCH IN RELATION TO THE TRACHEA AND BRONCHI. A LEFT AORTIC ARCH (LAA) WOULD BE ON THE LEFT OF THE TRACHEA AND RUN OVER THE LEFT BRONCHUS; WHEREAS A RIGHT AORTIC ARCH (RAA) WOULD BE ON THE RIGHT OF THE TRACHEA AND RUN OVER THE RIGHT BRONCHUS. A DOUBLE AORTIC ARCH (DAA) OCCURS WHEN THERE ARE TWO TRANSVERSE AORTIC ARCHES RUNNING OVER THE TRACHEA AND BOTH BRONCHI. NORMALLY, THE ARCH SIDEDNESS IS TOWARDS THE LEFT AND THERE IS NO ARTERIAL DUCT BEHIND THE TRACHEA OR ESOPHAGUS. IN CASES OF THE VASCULAR RING THERE IS A PATENT VESSEL, AN ATRETIC VESSEL OR ITS REMNANTS CIRCLING THE TRACHEA OR ESOPHAGUS. THE MOST COMMON AORTIC ARCH ASSOCIATION WITH A VASCULAR RING IS A DAA OR A RIGHT AORTIC ARCH WITH ABERRANT (RETRO-ESOPHAGEAL) LEFT SUBCLAVIAN ARTERY. THIS ACTIVITY REVIEWS THE EVALUATION AND MANAGEMENT OF VASCULAR RINGS AND EXPLAINS THE ROLE OF THE INTERPROFESSIONAL TEAM IN MANAGING PATIENTS WITH THIS CONDITION.