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Mid-term results of vascular ring surgery

Part of: Surgery

Published online by Cambridge University Press:  15 November 2021

Gabriel Amir Open the ORCID record for Gabriel Amir [Opens in a new window] ,
Niv Soffair ,
Elchanan Bruckheimer ,
Elchanan Nachum ,
Tommy Shoenfeld ,
Amichai Rotstein ,
Georgy Frenkel  and
Einat Birk
Gabriel Amir*
Affiliation:
Division of Pediatric and Congenital Cardiac Surgery, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Niv Soffair
Affiliation:
Division of Pediatric and Congenital Cardiac Surgery, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Elchanan Bruckheimer
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Pediatric Cardiology, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
Elchanan Nachum
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Pediatric Intensive Care Unit, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
Tommy Shoenfeld
Affiliation:
Pediatric Intensive Care Unit, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
Amichai Rotstein
Affiliation:
Department of Pediatric Cardiology, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
Georgy Frenkel
Affiliation:
Division of Pediatric and Congenital Cardiac Surgery, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
Einat Birk
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Pediatric Cardiology, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
*
Author for correspondence: Dr G. Amir, Division of Pediatric and Congenital Cardiac Surgery, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel. Tel: 972504057199. Fax: 97237604853. E-mail: gabiamir@gmail.com; gabriela@clalit.org.il
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Abstract

Background:

Vascular rings cause respiratory symptoms in children. Treatment consists of surgical division; however, data regarding mid-term results are scarce. The purpose of this study was to evaluate clinical results of vascular ring surgery.

Methods:

Retrospective chart review of consecutive patients who underwent vascular ring surgery. Mid-term follow-up consisted of clinic visits and telephone questionnaire over a 1-year period sampling at five points in time.

Results:

Follow-up of 85 patients who underwent vascular rings surgery revealed significant symptomatic improvement within 6 months. In total, 50% were symptomatic to some degree at their last documented clinic visit complaining of stridor (36.8%), cough (34.2%), wheezing (10.5%), dyspnoea on exertion (10.5%), or recurrent respiratory infections (23.7%). By telephone questionnaires, 83% described a significant improvement in respiratory symptoms, 63.4% had some residual symptoms, 36.6% stridor, 38.8% chronic cough, 32.4% bronchodilator use,18.3% had at least one episode of pneumonia per year, 31% of children had dyspnoea or respiratory limitation, and 12.7% while doing physical activities. We found no association between the age at surgery or anatomic variant to the presence of symptoms at mid-term follow-up.

Conclusions:

Surgical division of vascular rings results in significant clinical improvement within 1 year; nevertheless, some patients remain symptomatic to some degree. We found no association between the age at surgery or anatomic variant to the presence of symptoms at mid-term follow-up. Further evaluation is warranted to assess the nature of residual symptoms and explore whether anatomical causes can be identified leading to surgical modifications.

Keywords

Vascular ring surgerysymptomslong term
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 9 , September 2022 , pp. 1415 - 1420
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Part of this work was presented as e-poster at the European Society of Cardiology Congress 2020.

Gabriel Amir and Niv Soffair contributed equally to this manuscript.

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