Anand R, Dooley K J, Williams W H, Vincent R N
Children's Heart Center, Emory University School of Medicine, Atlanta, Georgia.
Pediatr Cardiol. 1994 Mar-Apr;15(2):58-61. doi: 10.1007/BF00817607.
Between January 1977 and January 1990, 44 patients with symptomatic vascular rings/slings required surgical intervention at this center. Nineteen patients had double aortic arch (group I); 13 patients had vascular ring consisting of right aortic arch, anomalous origin of the left subclavian artery, and ligamentum arteriosus (group II); eight patients had innominate artery compression (group III); and four patients had pulmonary artery sling (group IV). Three patients had complex congenital heart defect and died secondary to it and are excluded from the study. Follow-up was obtained on 31 patients (76%). The follow-up period ranged from 0.4 years to 10.9 years, with a mean of 3.6 years. Seventy percent of the overall group were asymptomatic, and 30% of patients continued to have upper and lower respiratory symptoms on late follow-up. One third of patients in groups I and II, who underwent surgical repair, continue to have symptoms. Patients who have persistent symptoms should be further evaluated with PFTs, MRI, and bronchoscopy, and may benefit from aortopexy. Patients with innominate artery compression and pulmonary artery sling do well soon after surgery with relief of most of their symptoms.
1977年1月至1990年1月期间，本中心有44例有症状的血管环/吊带患者需要接受手术干预。19例患者为双主动脉弓（I组）；13例患者的血管环由右主动脉弓、左锁骨下动脉异常起源和动脉韧带组成（II组）；8例患者有无名动脉压迫（III组）；4例患者有肺动脉吊带（IV组）。3例患者有复杂先天性心脏缺陷并因此死亡，被排除在研究之外。对31例患者（76%）进行了随访。随访期为0.4年至10.9年，平均为3.6年。总体组中70%无症状，30%的患者在后期随访中仍有上、下呼吸道症状。接受手术修复的I组和II组患者中有三分之一仍有症状。有持续症状的患者应通过肺功能测试、磁共振成像和支气管镜检查进行进一步评估，可能会从主动脉固定术中获益。无名动脉压迫和肺动脉吊带患者术后恢复良好，大多数症状得到缓解。
