Symptom persistence after vascular ring repair in children
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Read the article on jpedsurg.org ↗Article · Jan 2020 · 1 min read
In brief
In brief
This retrospective study of 63 pediatric vascular ring repairs found that despite safe surgical outcomes with no operative mortality, symptom persistence remains common—45% of aberrant subclavian artery and 65% of double aortic arch patients had ongoing breathing or swallowing difficulties postoperatively. The findings highlight the need for further investigation into persistent symptoms following vascular ring division.
Written by the GCMD Library team from the article.
Abstract
Purpose
Vascular rings are often diagnosed after evaluation for swallowing and breathing difficulties. Data regarding symptoms following vascular ring repair is sparse. We sought to determine whether symptoms persist using chart review and a survey.
Methods
Sixty-three patients underwent open vascular ring repair from July 2007 to May 2018. Data regarding vascular anatomy, demographics, pre- and postoperative symptoms, and chromosomal abnormalities were collected. Freedom from reoperation, 30-day mortality, and complications were assessed. Patient families were contacted for a symptom focused survey.
Results
The median age of surgical intervention was 14.4 months (IQR 5.8–34.7 months) for single aortic arches with an aberrant subclavian artery (SAA), and 5.3 months (IQR 1.3–10.1 months) for double aortic arches (DAA) (Table). Prior to surgery, all but two SAA were symptomatic. There was no operative mortality. Three patients required re-exploration for chylothorax, and three required late aortopexy. At last follow-up, 45% (18/40) SAA and 65% (15/23) DAA had post-operative symptoms. Fourteen patient families completed the symptom survey (10 SAA, 4 DAA). Five SAA had breathing and swallowing symptoms, and 3 SAA and 3 DAA had breathing difficulties.
Conclusions
Open vascular ring repair remains a safe repair. However, further investigation of the persistent symptoms in these patients is merited.
Study Type / Level of Evidence
Retrospective Comparative Study, Level III