title: Early and late outcomes after surgical management of congenital vascular rings.
abstract: Persistent respiratory or feeding problems in children may be associated with a congenital vascular ring. Surgical management is fairly standardized, but long-term outcomes are not well described. This study aims to investigate clinical presentation, surgical treatment, and risk factors for early mortality and late outcome. Our database revealed 62 surgically treated vascular ring patients between 1993 and 2014. Double aortic arch was the most common diagnosis (53%). Median age at operation was 1 year. Symptoms were mainly respiratory (89%) and feeding problems (32%). Median extubation time and hospital stay were 4 h and 5 days. Mean follow-up was 7.8 ± 5.8 years. Early mortality was 8% and was related to anatomical diagnosis, concomitant anomalies, and a need for preoperative intubation. Freedom from residual symptoms at 1 and 6 months was 63 and 82%, respectively. Freedom from inhalation therapy at the last follow-up was 82% and was influenced by a type of vascular ring and preoperative ventilation. Dysphagia symptoms always disappeared.
  
  
  CONCLUSIONS
  Surgical relief of tracheoesophageal compression is commonly effective in vascular ring anomalies. Respiratory symptoms necessitating chronic inhalation therapy only persist in a minority of children. Patients with double aortic arch are at increased risk to remain symptomatic, particularly with infectious exacerbations.
authors.affiliation: Department of Congenital Cardiac Surgery, Cardiac Center, University Hospital Ghent, Ghent, Belgium. katrien.francois@ugent.be.
authors.forename: Katrien
authors.initials: K
authors.lastname: François
authors.affiliation: Department Pediatric Cardiology, Cardiac Center, University Hospital Ghent, Ghent, Belgium.
authors.forename: Joseph
authors.initials: J
authors.lastname: Panzer
authors.affiliation: Department Pediatric Cardiology, Cardiac Center, University Hospital Ghent, Ghent, Belgium.
authors.forename: Katya
authors.initials: K
authors.lastname: De Groote
authors.affiliation: Department Pediatric Cardiology, Cardiac Center, University Hospital Ghent, Ghent, Belgium.
authors.forename: Kristof
authors.initials: K
authors.lastname: Vandekerckhove
authors.affiliation: Department Pediatric Cardiology, Cardiac Center, University Hospital Ghent, Ghent, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: De Wolf
authors.affiliation: Department Pediatric Cardiology, Cardiac Center, University Hospital Ghent, Ghent, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: De Wilde
authors.affiliation: Department of Pediatric Cardiology, University Hospital Antwerp, Antwerp, Belgium.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Marchau
authors.affiliation: Department of Neonatology, Sint-Jan Hospital, Bruges, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: De Caluwe
authors.affiliation: Department of Pediatric Cardiology, University Hospital Brussels, Brussels, Belgium.
authors.forename: Abraham
authors.initials: A
authors.lastname: Benatar
authors.affiliation: Department of Congenital Cardiac Surgery, Cardiac Center, University Hospital Ghent, Ghent, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Bové
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery*; D002675:Child, Preschool; D004940:Esophageal Stenosis / Q000151:congenital / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D012189:Retrospective Studies; D013908:Thoracotomy; D014135:Tracheal Stenosis / Q000151:congenital / Q000601:surgery*; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications / Q000601:surgery*
keywords: Dysphagia; Late outcome; Surgical treatment; Tracheoesophageal compression; Vascular ring