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Pediatrics Conference 2018
Journal of Pediatric Care
ISSN: 2471-805X
Page 41
March 26-27, 2018
Edinburgh, Scotland
2
nd
Edition of International Congress on
Pediatrics
P
ersistent 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 1993-2014. Double
aortic arch was the most common diagnosis (53%), followed
by right aortic arch with aberrant left subclavian artery (39%). A
Kommerell’s diverticulum was present in 24 patients. Symptoms
were mainly respiratory (89%) and feeding problems (32%).
Median age at operation was 1 year. Median extubation time and
hospital stay were 4 hours (interquartile range (IQR) 2-16 h) and
5 days (IQR 3.8-7.3 days). Mean follow-up was 7.8±5.8 years.
Early mortality was 8% and was related to anatomical diagnosis,
concomitant anomalies, and need for preoperative intubation.
Freedom from residual symptoms at 1 and 6 months was 63%
and 82% respectively. Freedom from inhalation therapy at last
follow-up was 82% and was influenced by type of vascular ring
and preoperative ventilation and dysphagia symptoms always
disappeared. Surgical relief of tracheoesophageal compression
is commonly effective in vascular ring anomalies. Respiratory
symptoms only persist in a minority of children. Patients with
double aortic arch are at increased risk to remain symptomatic,
necessitating supportive inhalation therapy lifelong or during
intercurrent respiratory infections. Severe repetitive respiratory
distress episodes during the first year of life must alert the
pediatrician for this clinical entity, asmost patients with a vascular
ring present early.
Biography
Katrien Francois is a Congenital Cardiac Surgeon at the University Hospital
Ghent, Belgium, and currently the Head of the Cardiac Surgery Department
at the same hospital. She received her surgical training at the University Hos-
pital Ghent, and congenital cardiac surgery training at Great Ormond Street
Hospital for Sick Children, London. She obtained her PhD with a thesis on
“Surgical palliation of the functionally univentricular heart”. She has pub-
lished more than 100 papers in peer-reviewed journals.
katrien.francois@ugent.beEarly and late outcomes after surgical management of
congenital vascular rings
Katrien Francois
Ghent University Hospital, Belgium
Katrien Francois, J Pediatr Care, Volume 4
DOI: 10.21767/2471-805X-C1-006