St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Vascular ring

    Right aortic arch with aberrant subclavian and left ligamentum

    Vascular ring is an abnormal formation of the aorta, the large artery that carries blood from the heart to the rest of the body. It is a congenital problem, which means it is present at birth.

    Causes

    Vascular ring is rare. It accounts for less than 1% of all congenital heart problems. The condition occurs as often in males as females. Some infants with vascular ring also have another congenital heart problem.

    Vascular ring occurs very early in the baby's development in the womb. Normally, the aorta develops from one of several curved pieces of tissue (arches). The body breaks down some of the remaining arches, while others form into arteries. Some arteries that should break down do not; this forms vascular rings.

    With vascular ring, some of the arches and vessels that should have changed into arteries or disappeared are still present when the baby is born. These arches form a ring of blood vessels, which encircles and presses down on the windpipe (trachea) and esophagus.

    Several different types of vascular ring exist. In some types, the vascular ring only partially encircles the trachea and esophagus, but it still can cause symptoms.

    Symptoms

    Some children with a vascular ring never develop symptoms. However, in most cases, symptoms are seen during infancy. Pressure on the windpipe (trachea) and esophagus can lead to breathing and digestive problems. The more the ring presses down, the more severe the symptoms will be.

    Breathing problems may include:

    • High-pitched cough
    • Loud breathing (stridor)
    • Repeated pneumonias or respiratory infections
    • Respiratory distress
    • Wheezing

    Eating may make breathing symptoms worse.

    Digestive symptoms are rare, but may include:

    • Choking
    • Difficulty eating solid foods
    • Difficulty swallowing (dysphagia)
    • Gastroesophageal reflux (GERD)
    • Slow breast or bottle feeding
    • Vomiting

    Exams and Tests

    The doctor will listen to the baby's breathing to rule out other breathing disorders such as asthma. Listening to the child's heart through a stethoscope can help identify murmurs and other heart problems.

    The following tests can help diagnose vascular ring:

    • Chest x-ray
    • Computed tomography (CT) scan of the heart
    • Camera down the throat to examine the airways (bronchoscopy)
    • Magnetic resonance imaging (MRI) of the heart
    • Ultrasound examination (echocardiogram) of heart
    • X-ray of blood vessels (angiography)
    • X-ray of the esophagus using a special dye to better highlight the area (esophagram or barium swallow)

    Treatment

    Surgery is usually performed as soon as possible on children with symptoms. The goal of surgery is to split the vascular ring and relieve pressure on the surrounding structures. The surgery is not very invasive. The procedure is usually done through a small surgical cut in the left side of the chest between the ribs.

    Changing the child's diet may help relieve the digestive symptoms of vascular ring. The doctor will prescribe medications (such as antibiotics) to treat any respiratory tract infections, if they occur.

    Children who don't have symptoms may not need treatment, but should be carefully watched to make sure the condition doesn't become worse.

    Outlook (Prognosis)

    How well the infant does depends on how much pressure the vascular ring is putting on the esophagus and trachea and how quickly the infant is diagnosed and treated.

    Surgery works well in most cases and often relieves symptoms right away. Severe breathing problems may take months to go away. Some children may continue to have loud breathing, especially when they are very active or have respiratory infections.

    Possible Complications

    When to Contact a Medical Professional

    Prevention

    References

    Bernstein D. Other congenital heart and vascular malformations. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011;chap 426.

    BACK TO TOP

    • Congenital heart defect ...

      Animation

    • Vascular ring

      illustration

    • Congenital heart defect ...

      Animation

    • Vascular ring

      illustration

    A Closer Look

      Self Care

        Tests for Vascular ring

          Review Date: 2/7/2012

          Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
          adam.com

          A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


          Back  |  Top
          About Us
          Contact Us
          History
          Mission
          Locations & Directions
          Quality Reports
          Annual Reports
          Honors & Awards
          Community Health Needs
          Assessment

          Newsroom
          Services
          Brain & Spine
          Cancer
          Heart
          Maternity
          Orthopedics
          Pulmonary
          Sleep Medicine
          Urgent Care
          Women's Services
          All Services
          Patients & Visitors
          Locations & Directions
          Find a Physician
          Tour St. Luke's
          Patient & Visitor Information
          Contact Us
          Payment Options
          Financial Assistance
          Send a Card
          Mammogram Appointments
          Health Tools
          My Personal Health
          mystlukes
          Spirit of Women
          Health Information & Tools
          Clinical Trials
          Health Risk Assessments
          Employer Programs -
          Passport to Wellness

          Classes & Events
          Classes & Events
          Spirit of Women
          Donate & Volunteer
          Giving Opportunities
          Volunteer
          Physicians & Employees
          For Physicians
          Remote Access
          Medical Residency Information
          Pharmacy Residency Information
          Physician CPOE Training
          Careers
          Careers
          St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
          Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile