Airway obstruction by congenital cardiovascular anomaly

Jeon, Kyoung Hee; Ahn, Yeon Hwa; Jung, Jin A; Chung, Eun Hee; Lee, Ju Suk; Park, Yong Min; Nam, Seung Yeon; Chang, Ki Young; Kang, I Seok; Lee, Heung Jai; Ahn, Kang Mo; Lee, Sang Il

Abstract

PURPOSE
This study was performed to review the clinical presentation, diagnostic methods, treatments and prognosis of children with vascular rings. METHOD: We reviewed the medical records of 7 patients with vascular ring who were admitted in Samsung medical center between 1996 and 2000 retrospectively. RESULT: Pulmonary artery sling was noted in 4 cases. Two cases had double aortic arch, and 1 case had right aortic arch with left ligamentum arteriosus and aberrant left subclavian artery. The mean age at onset of symptoms was 3.2 months(from birth to 11 months). The mean age at diagnosis was 7.0 months(from 6 weeks to 15 months). Presenting symptoms and signs were respiratory difficulty, stridor, chest retraction, coughing, grunting, wheezing, sputum, cyanosis, choking, dysphagia, and poor feeding. All patients with pulmonary artery sling had tacheobronchial and/or pulmonary anomalies and cardiac defects were associated in two of them. Surgical repair was done successfully for the patients with double aortic arch or right aortic arch, but three deaths occurred to the patients with pulmonary artery sling combined with bronchial anomaly.
CONCLUSION
Vascular ring should be considered especially for infants with respiratory distress or chronic respiratory symptoms. Associated anomalies are likely to affect the prognosis in these patients.