Symptom persistence after vascular ring repair in children.

J Pediatr Surg

Section of Pediatric Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine; One Children's Place, Campus Box 8234, St. Louis, MO 63110.

Published: November 2020

AI Article Synopsis

  • Vascular rings are commonly diagnosed when patients experience difficulties with swallowing and breathing, but there is limited information on symptoms after surgical repair.
  • The study involved 63 patients who underwent surgery between 2007 and 2018, evaluating pre- and postoperative symptoms, complications, and the need for further operations.
  • Results showed that while the surgery was generally safe, a significant number of patients (45% with single aortic arches and 65% with double aortic arches) continued to experience symptoms after the procedure, indicating the need for more research on persistent issues.

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.

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Source
http://dx.doi.org/10.1016/j.jpedsurg.2019.12.022DOI Listing

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