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Pediatric Otolaryngology

(428) Respiratory and Swallowing Outcomes of Vascular Ring Repair

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • Ashley E. Young, BS

    Medical Student
    Northwestern University
    Lincolnshire, Illinois, United States

    • Senior Author(s)

  • IH

    Inbal Hazkani, MD

    Faculty
    Lurie Childrens Hospital/ Northwestern University
    Chicago, Illinois, United States

    • Co-Author(s)

  • OE

    Osama Eltayeb, MD

    Lurie Children's Hospital, Northwestern university, USA

    • Co-Author(s)

  • Doris Farje, BA

    Medical Student
    Northwestern University
    Chicago, Illinois, United States

    • Co-Author(s)

  • Saied Ghadersohi, MD

    Assistant Professor
    Lurie Children's Hospital, Northwestern University
    Chicago, IL, United States

Disclosure(s):
Inbal Hazkani, MD: No relevant relationships to disclose.
Doris Farje, BA: No relevant relationships to disclose.
Ashley E. Young, BS: No relevant relationships to disclose.


Introduction: Vascular rings are often associated with respiratory and swallowing difficulties due to tracheal or esophageal compression. The long-term effect of tracheal and esophageal remodeling and the persistence of symptoms following a vascular ring repair have scarcely been reported. The goal of our study is to evaluate the respiratory and swallowing outcomes of vascular ring repair.

Methods: A retrospective cohort study of children who underwent vascular ring repair between 2010-2022 in a tertiary-care children’s hospital

Results: There were 108 patients enrolled: sixty-two patients (57.4%) with a right aortic arch, 40 patients (37.0%) with a double aortic arch, and 3 patients (2.8%) with other vascular rings. Forty-three (39.8%) patients were diagnosed prenatally. Of the 65 patients (60.19%) diagnosed postnatally, 35 (53.85%) had either respiratory or swallowing symptoms as the indication for diagnostic workup. Persistent respiratory and swallowing symptoms were noted in 34 (31.5%) and 30 (27.8%) patients, respectively, within a year of surgical repair. Fourteen patients underwent repeated laryngoscopy and bronchoscopy that demonstrated residual compression; however, only 2 (1.9%) patients required tracheostomy tube placement, and 8-out-of-9 patients were weaned off positive pressure airway support. No differences were noted in demographics, type of vascular ring, comorbidities, and preoperative symptoms between patients with residual symptoms and patients with no residual symptoms.

Conclusions: Persistent respiratory and swallowing symptoms after vascular ring repair are not uncommon. Postoperative evaluation should be pursued and treatment considered as appropriate.