Vascular ring causing tracheal compression in an adult patient

doi:10.1016/S0003-4975(02)04832-4

The Annals of Thoracic Surgery

Volume 75, Issue 6, June 2003, Pages 1959-1960

https://doi.org/10.1016/S0003-4975(02)04832-4 Get rights and content

Abstract

A 65-year-old woman was referred for evaluation because of a few years’ history of inspiratory obstruction without dysphagia. A right aortic arch with mirror image bracheocephalic vessels narrowing the trachea was considered to be the reason for the dyspnea. Immediate decompression of the trachea and symptomatic relief was achieved through surgical treatment.

Section snippets

Comment

Spirometry is neither specific nor sensitive as a diagnostic tool for surgical evaluation, and therefore not valid for indication of surgical therapy for vascular rings [4]. Indication for surgical treatment should be based on clinical symptoms and imaging diagnostic.

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There are more references available in the full text version of this article.

Cited by (10)

Tracheobronchial and pulmonary parenchymatous congenital abnormalities requiring surgical treatment in adults
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La plupart des malformations trachéobronchiques et parenchymateuses pulmonaires sont découvertes dans les premiers mois de la vie, mais certaines peuvent n’être diagnostiquées qu’à l’âge adulte. Sont concernés l’arbre trachéobronchique (sténose trachéale et/ou bronchique, kyste bronchogénique, atrésie bronchique, fistule œsotrachéale, fistule œsobronchique, et diverticule trachéal) et le parenchyme pulmonaire (séquestration, malformation adénoïde kystique, emphysème lobaire, hypoplasie lobaire ou pulmonaire). Une prise en charge chirurgicale est parfois nécessaire, et ces cas rares doivent être connus afin de ne pas négliger une malformation potentiellement dangereuse.
Most tracheobronchial and parenchymatous congenital abnormalities of the respiratory system are diagnosed in early life. However, some lesions may be initially silent and diagnosed only in adulthood. These cases included congenital abnormalies of the tracheobronchial tract (tracheal and/or bronchial stenosis, bronchogenic cysts, bronchial atresia, oesotracheal fistula, oesobronchial fistula, and tracheal diverticulum), and lung parenchyma itself (pulmonary sequestration, congenital cystic adenomatoïd malformation, lobar emphysema, lobar or lung hypoplasia). To avoid dreadful complications, these rare cases deserve surgical management, and must be known by chest physicians and surgeons.
Complete vascular ring presenting in adulthood: An unusual management dilemma
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Citation Excerpt :
If tracheal embarrassment is evident despite ligamentum release, formal Kommerell resection with division/reimplantation of aberrant vessels should be performed through a right thoracotomy 6 weeks later.3
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The maximal FVL during exercise after surgery was improved with no significant fall in peak inspiratory flow (PIF), PEF, FEV1 or inspiratory capacity (IC) compared with resting values (figure 3). Primary presentation of a congenital complete vascular ring in adulthood is unusual as it is likely to cause severe symptoms in infancy or early childhood leading to diagnosis.1–3 Increased tracheal compression during exercise is thought to be caused by aortic dilatation due to increased arterial pressure.
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Case reportVascular ring causing tracheal compression in an adult patient

Abstract

Section snippets

Comment

J Am Coll Cardiol

Resection of a right atrial metastatic melanoma with unknown origin of primary tumor

Eur J Cardiothorac Surg

Right-sided aortic arch

Folia Morphol (Warsz)

Vascular ringsa rare cause of common respiratory symptoms

Acta Paediatr

Case report
Vascular ring causing tracheal compression in an adult patient