title: Natural History of Asymptomatic and Unrepaired Vascular Rings: Is Watchful Waiting a Viable Option? A New Case and Review of Previously Reported Cases.
abstract: Vascular rings are a rare form of congenital heart disease in which abnormal aortic arch anatomy leads to encircling of the esophagus and/or trachea by the aortic vasculature. Symptoms can develop from this and prompt the need for surgery. A natural history study has been done on mildly symptomatic patients but no such study has been done on asymptomatic patients. We present a case report of three children with asymptomatic vascular rings who continue to receive follow-up without intervention and review all published cases of asymptomatic or unrepaired vascular rings. Clinical observation of asymptomatic and mildly symptomatic vascular rings, regardless of aortic arch anatomy, seems to be a safe approach. Children with mild symptoms almost invariably seem to have resolution of their symptoms by four years of age.
authors.affiliation: Department of Cardiology and Department of Cardiothoracic Surgery, Children's Hospital of Wisconsin, 9000 Wisconsin Avenue, Milwaukee, WI 53226, USA. rloomba@chw.org.
authors.forename: Rohit S
authors.initials: RS
authors.lastname: Loomba
keywords: asymptomatic; double aortic arch; right aortic arch; unrepaired; vascular anomaly; vascular ring