Lozsádi K, Hartyánszky I, Hüttl I, Sapi E, Székely A, Király L
Grud Serdechnososudistaia Khir. 1991 Oct(10):6-9.
Operation was carried out on 143 children (aged from 5 days to 16 years) for tracheobronchial obstruction caused by vascular rings. A double arch of the aorta was found in 50 patients, double arch of the aorta with atresia of the left arch--in 50 patients, right arch of the aorta with ligamentum arteriosum--in 30, left arch of the aorta with an aberrant right subclavian artery--in 10, and a pulmonary loop in 3 patients. Stridor was the main clinical manifestation of the vascular ring. The diagnosis was established by means of two-projection chest radiography and esophagography with a barium meal, bronchoscopy, and angiography. The surgical approach was gained through a posterolateral (left or right) thoracotomy. No deaths occurred during the operation. Two infants died in the postoperative period from a severe bacterial infection of the respiratory tract. On the basis of a rich clinical experience the authors came to the conclusion that the presence of a right aortic arch (except for cases with situs inversus) is always pathognomic because it either causes the appearance of a vascular ring without any intracardiac anomaly, or it may be combined with a congenital heart disease in which a vascular ring is usually not encountered (tetralogy of Fallot, truncus arteriosus communis, etc.). The authors never encountered atresia of a segment of the right aortic arch. The last-named was either patent or absent.
对143例（年龄从5天至16岁）因血管环导致气管支气管梗阻的儿童进行了手术。50例患者发现主动脉双弓，50例患者为主动脉双弓伴左弓闭锁，30例患者为右主动脉弓伴动脉韧带，10例患者为左主动脉弓伴迷走右锁骨下动脉，3例患者为肺血管环。喘鸣是血管环的主要临床表现。通过胸部双平面X线摄影、钡餐食管造影、支气管镜检查和血管造影进行诊断。手术入路通过后外侧（左或右）开胸获得。术中无死亡病例。2例婴儿术后死于严重的呼吸道细菌感染。基于丰富的临床经验，作者得出结论，右主动脉弓的存在（除镜像右位心病例外）总是具有病理特征性，因为它要么导致无任何心内异常的血管环出现，要么可能与通常不伴有血管环的先天性心脏病（法洛四联症、共同动脉干等）合并存在。作者从未遇到过右主动脉弓某一段闭锁的情况。后者要么通畅，要么不存在。
