Vascular ring

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Associate Editors-In-Chief: ; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]

Overview
A vascular ring is a congenital defect in which there is an abnormal formation of the aorta and/or its surrounding blood vessels. The trachea and esophagus are completely encircled and sometimes compressed by a "ring" formed by these vessels, which can lead to breathing and digestive difficulties.

Pathophysiology
Most often this is because of persistence of the double aortic arch after the second month of fetal life. A less common ring is present with a right aortic arch instead of the usual left-sided aortic arch which compresses the esophagus and trachea because of the persistence of a ductal ligament (from fetal circulation) that may connect between the aorta on the front and the left subclavian artery posteriorly going to the left arm.

Symptoms
The two arches surround the esophagus and trachea which if sufficiently constrictive cause the breathing or swallowing difficulties.

Additional Resources

 * Moss and Adams' Heart Disease in Infants, Children, and Adolescents Hugh D. Allen, Arthur J. Moss, David J. Driscoll, Forrest H. Adams, Timothy F. Feltes, Robert E. Shaddy, 2007 ISBN 0781786843