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Vascular Ring—Child

Definition

A vascular ring is a defect of the aorta and nearby large vessels. The aorta is the large artery that carries blood from the heart to the body. When the aorta and nearby large vessels form in abnormal positions, the trachea and esophagus can become constricted by the “ring” formed by these abnormal vessels. Examples of this type of defect include:

Double aortic arch

Right aortic arch

While vascular ring may be detected in infancy, it is often discovered later in life.

Heart and Main Vessels

Causes

Vascular ring is a congenital defect. This means that the baby is born with the condition. During fetal growth in the womb, the large vessels near the heart do not develop normally. It is not known exactly why some children’s vessels develop in this way.

Risk Factors

Specific risk factors for vascular ring are not known.

Symptoms

Symptoms vary and can range from mild to severe. They may include:

Trouble breathing (wheezing, coughing, noisy breathing)

Lung infections

Poor feeding of solid food (eg, vomiting or choking)

Trouble swallowing

Acid reflux

These symptoms may be caused by other conditions. If your child has any of these, tell the doctor right away.

Diagnosis

Your doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests may include:

Echocardiogram —an imaging test that uses sound waves to look at the size, shape, and motion of the heart

CT scan —a type of x-ray that uses a computer to make pictures of structures inside the chest

MRI scan —a test that uses magnetic waves to make pictures of structures inside the body

Chest x-ray —an imaging test that uses low amounts of radiation to create an image of the chest

Electrocardiogram —a test that measures the electrical activity of the heart

Upper gastrointestinal series —a series of x-rays of the esophagus, stomach, and duodenum (the first part of the small intestine)

Bronchoscopy —a visual exam of the air passages leading into the lungs

Treatment

Talk with your doctor about the best treatment plan for your child. Treatment options include:

Surgery

The goal of surgery is to divide the vascular ring and relieve compression on the trachea and esophagus. This surgery may even be done if your child has minor symptoms.

Other Treatments

Before surgery, the doctor will treat your child’s symptoms. For example, the doctor will make sure that your child gets proper nutrition if he has swallowing problems. If your child has a bacterial respiratory infection, he will be treated with antibiotics.

Lifelong Monitoring

Your child will have regular exams from a heart specialist.

Prevention

There is no way to prevent formation of a vascular ring. Getting appropriate prenatal care is always important.

RESOURCES:

American Family Physician

http://www.aafp.org/

American Heart Association

http://www.americanheart.org/

CANADIAN RESOURCES:

Canadian Cardiovascular Society

http://www.ccs.ca/

Heart and Stroke Foundation of Canada

http://ww2.heartandstroke.ca/splash/

References:

Children’s Hospital Boston. Vascular ring. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1942/mainpageS1942P0.html . Accessed July 23, 2010.

Cincinnati Children’s Hospital. Vascular rings. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/heart-encyclopedia/anomalies/rings.htm . Accessed July 23, 2010.

Johns Hopkins University, Cove Point Foundation. Vascular ring. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=vascularring2 . Accessed July 9, 2010.

Last reviewed June 2012 by Kari Kassir, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.