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Early and late outcomes after surgical management of congenital vascular rings

(2017) EUROPEAN JOURNAL OF PEDIATRICS. 176(3). p.371-377
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Abstract
Persistent 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 and 2014. Double aortic arch was the most common diagnosis (53%). Median age at operation was 1 year. Symptoms were mainly respiratory (89%) and feeding problems (32%). Median extubation time and hospital stay were 4 h and 5 days. Mean follow-up was 7.8 +/- 5.8 years. Early mortality was 8% and was related to anatomical diagnosis, concomitant anomalies, and a need for preoperative intubation. Freedom from residual symptoms at 1 and 6 months was 63 and 82%, respectively. Freedom from inhalation therapy at the last follow-up was 82% and was influenced by a type of vascular ring and preoperative ventilation. Dysphagia symptoms always disappeared. Conclusion: Surgical relief of tracheoesophageal compression is commonly effective in vascular ring anomalies. Respiratory symptoms necessitating chronic inhalation therapy only persist in a minority of children. Patients with double aortic arch are at increased risk to remain symptomatic, particularly with infectious exacerbations.
Keywords
Vascular ring, Tracheoesophageal compression, Dysphagia, Surgical treatment, Late outcome, TRACHEAL STENOSIS, EXPERIENCE

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Chicago
François, Katrien, Joseph Panzer, Katya De Groote, Kristof Vandekerckhove, Daniël De Wolf, Hans De Wilde, Fabienne Marchau, Wim De Caluwe, Abraham Benatar, and Thierry Bové. 2017. “Early and Late Outcomes After Surgical Management of Congenital Vascular Rings.” European Journal of Pediatrics 176 (3): 371–377.
APA
François, K., Panzer, J., De Groote, K., Vandekerckhove, K., De Wolf, D., De Wilde, H., Marchau, F., et al. (2017). Early and late outcomes after surgical management of congenital vascular rings. EUROPEAN JOURNAL OF PEDIATRICS, 176(3), 371–377.
Vancouver
1.
François K, Panzer J, De Groote K, Vandekerckhove K, De Wolf D, De Wilde H, et al. Early and late outcomes after surgical management of congenital vascular rings. EUROPEAN JOURNAL OF PEDIATRICS. 2017;176(3):371–7.
MLA
François, Katrien et al. “Early and Late Outcomes After Surgical Management of Congenital Vascular Rings.” EUROPEAN JOURNAL OF PEDIATRICS 176.3 (2017): 371–377. Print.
@article{8524835,
  abstract     = {Persistent 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 and 2014. Double aortic arch was the most common diagnosis (53\%). Median age at operation was 1 year. Symptoms were mainly respiratory (89\%) and feeding problems (32\%). Median extubation time and hospital stay were 4 h and 5 days. Mean follow-up was 7.8 +/- 5.8 years. Early mortality was 8\% and was related to anatomical diagnosis, concomitant anomalies, and a need for preoperative intubation. Freedom from residual symptoms at 1 and 6 months was 63 and 82\%, respectively. Freedom from inhalation therapy at the last follow-up was 82\% and was influenced by a type of vascular ring and preoperative ventilation. Dysphagia symptoms always disappeared. 
Conclusion: Surgical relief of tracheoesophageal compression is commonly effective in vascular ring anomalies. Respiratory symptoms necessitating chronic inhalation therapy only persist in a minority of children. Patients with double aortic arch are at increased risk to remain symptomatic, particularly with infectious exacerbations.},
  author       = {Fran\c{c}ois, Katrien and Panzer, Joseph and De Groote, Katya and Vandekerckhove, Kristof and De Wolf, Dani{\"e}l and De Wilde, Hans and Marchau, Fabienne and De Caluwe, Wim and Benatar, Abraham and Bov{\'e}, Thierry},
  issn         = {0340-6199},
  journal      = {EUROPEAN JOURNAL OF PEDIATRICS},
  language     = {eng},
  number       = {3},
  pages        = {371--377},
  title        = {Early and late outcomes after surgical management of congenital vascular rings},
  url          = {http://dx.doi.org/10.1007/s00431-017-2850-y},
  volume       = {176},
  year         = {2017},
}

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