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A vascular ring happens when the aorta or its branches form a complete ring around the trachea (windpipe) and the esophagus, the tube that leads from the throat to the stomach.
A vascular ring is a birth defect that can cause issues with breathing and eating. Children with a vascular ring may have symptoms as a baby or during early childhood.
It’s normal for a fetus in the womb to have some arches of tissue near the trachea and esophagus. As the baby develops, these arches should either change to become arteries or completely disappear. Rarely, some of these arches do not disappear and turn into vascular rings.
There are several types of rings, named for where and how they formed. These are the most common types:
The specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine — the leading providers of pediatric heart care in Louisville and Southern Indiana — can help your child with a vascular ring.
The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute have the skills and experience to provide a precise diagnosis and determine what treatment, if any, is needed.
Norton Children’s has a network of outreach diagnostic and treatment services throughout Kentucky and Southern Indiana.
Most babies with a vascular ring will have symptoms caused by the pressure the rings put on their trachea and esophagus. Some children with a vascular ring have no symptoms as babies, but develop symptoms as they get older.
Pressure on the trachea can cause breathing issues such as:
Pressure on the esophagus can cause issues such as:
A vascular ring can form when the baby’s aorta does not develop the way it should during pregnancy. Doctors don’t know why this happens.
A pediatric cardiologist will examine your child, listen to his or her heart, and ask about your child’s symptoms and health history, as well as your family’s health history. The following tests may provide more details:
If your child has vascular rings but doesn’t have symptoms, your doctor will want to see your child regularly to check whether any symptoms develop.
Children who have symptoms from vascular rings will need surgery. The procedure is not open heart surgery but does involve surgery inside the chest. In many cases, the surgeon makes a small incision on the left side of the chest and goes between the ribs to make the repair.
DOUBLE AORTIC ARCH SURGERY
The surgeon will cut and stitch closed one of the arches, usually the left, so the aorta no longer encircles or puts pressure on the trachea or esophagus.
RIGHT AORTIC ARCH WITH LEFT LIGAMENTUM ARTERIOSUM SURGERY
The surgeon divides the ligamentum arteriosum so that it no longer puts pressure on the trachea or esophagus. The right aortic arch remains, as a person can live with this type of defect.