[Diagnostic characterization and morbi-mortality in pediatric patients with diagnosis of vascular ring].

Abstract

Objective: To analyze the clinical characteristics and natural history of pediatric patients with a diagnosis of vascular ring.

Method: We retrospectively studied the records of 110 patients of pediatric age, from January 2014 to December 2022, with the following variables: age, clinical manifestations, associated cardiac lesions, diagnostic method and surgical approach.

Results: Of the total, 60 (55%) were female and 50 (45%) were male. Diagnosis was made, on average, at 47 months of life. The vascular rings found were aberrant subclavian artery (82.8%), circumflex aorta (8.1%), double aortic arch (6.3%) and left pulmonary artery sling (1.8%). Ninety percent of the cases were associated with other congenital heart disease, mainly tetralogy of Fallot, pulmonary valve atresia and ventricular septal defect. Forty-five percent of the cases produced compression of structures and 77% of the patients were asymptomatic. Twenty-one percent of the patients received surgical treatment of which 35% presented postoperative complications: sepsis (26%), mediastinitis (4.3%) and cardiogenic shock (4.3%). Postoperative mortality was 17%. Within the natural history of symptomatic patients who remained in expectant management, 100% resolved their symptoms.

Conclusions: In this series, the most frequent type of vascular ring was aberrant subclavian artery. Diagnosis is late due to the lack of specificity of its symptoms, being mainly respiratory. The symptoms of mild involvement resolve in most cases, associated with the growth of the affected structures and their laxity.