title: Video assisted thoracoscopic surgery cases with right-sided aortic arch aneurysm and complete vascular ring: Case report.
abstract: BACKGROUND
  Right-sided aortic arch with aberrant left subclavian artery and ligamentum arteriosum, after double aortic arch, is the second most common complete vascular ring. It was traditionally treated by open surgical thoracotomy and recently video assisted thoracoscopic surgery (VATS) has been used in some cases.
  
  
  METHODS
  We describe the cases of two infants who presented with gastroesophageal reflux, dyspnea, dysphagia secondary to aneurysmal dilatation of the retroesophageal arch confirmed by imaging data. VATS procedure was performed through a left thoracoscopic approach. Ligamentum arteriosus compressed esophagus was clipped, sectioned and then released the esophagus in one case; also, In the second case, we clipped and sectioned aorta, distal to the origin of aberrant left subclavian artery.
  
  
  CONCLUSIONS
  CT angiography and MRI are known to be the most effective available imaging methods for vascular ring detection. Also, there are several surgical approaches to vascular rings such as, thoracotomy and thoracoscopy. There is a large body of evidence confirming the safety, efficacy and convenience of VATS as a therapeutic option for congenital heart disease including right-sided aortic arch and aberrant left subclavian artery.
  
  
  CONCLUSIONS
  VATS is a less invasive and safe strategy for management of right-sided aortic arch with aberrant left subclavian artery and ligamentum arteriosum.
authors.affiliation: Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Nezafati
authors.affiliation: Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: Pouya_dg@yahoo.com.
authors.forename: Pouya
authors.initials: P
authors.lastname: Nezafati
keywords: Aberrant left subclavian artery; VATS; Vascular rings