Carlos Nieto-Moral, Enrique García-Torres, Francisco Javier Arias-Dachary, Lorenzo Boni
{"title":"血管环手术:何时介入?回顾我们的案例并介绍管理算法。","authors":"Carlos Nieto-Moral, Enrique García-Torres, Francisco Javier Arias-Dachary, Lorenzo Boni","doi":"10.1016/j.circv.2024.06.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The term vascular ring encompasses different anatomical variants, the result of anomalous embryonic development of the primitive aortic arches, with the potential to cause injuries to the airway and/or digestive tract. Despite a more frequent, early and/or prenatal diagnosis, there are no clear management recommendations in clinical guidelines.</div><div>We present the management algorithm of this center, supported by the literature and a review of the results of patients operated on there.</div></div><div><h3>Methods</h3><div>Retrospective review of vascular ring interventions at the Hospital Universitario 12 de Octubre in Madrid, between January 2014 and March 2023, and analysis of the literature.</div></div><div><h3>Results</h3><div>Between January 2014 and March 2023, a total of 31 patients were operated on without any deaths being recorded. In 67.7% of cases the approach was thoracoscopic, and prenatal diagnosis was performed in 82.7% of susceptible cases.</div></div><div><h3>Conclusions</h3><div>Early surgery is considered to avoid sequelae of this pathology, without significant differences in surgical complications or associated with the type of approach, thoracoscopic or thoracotomy/sternotomy.</div><div>They meet the criteria for surgical indication: patients with symptomatic vascular rings when they first appear, asymptomatic complete vascular rings with a decrease in the airway lumen ≥ 50% in dynamic imaging tests, and all elective double aortic arches around 6 months of age, regardless of clinical symptoms and degree of airway compression.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 5","pages":"Pages 244-252"},"PeriodicalIF":0.3000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cirugía del anillo vascular: ¿cuándo intervenir? Revisión de nuestra casuística y presentación de un algoritmo de manejo\",\"authors\":\"Carlos Nieto-Moral, Enrique García-Torres, Francisco Javier Arias-Dachary, Lorenzo Boni\",\"doi\":\"10.1016/j.circv.2024.06.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction and objectives</h3><div>The term vascular ring encompasses different anatomical variants, the result of anomalous embryonic development of the primitive aortic arches, with the potential to cause injuries to the airway and/or digestive tract. Despite a more frequent, early and/or prenatal diagnosis, there are no clear management recommendations in clinical guidelines.</div><div>We present the management algorithm of this center, supported by the literature and a review of the results of patients operated on there.</div></div><div><h3>Methods</h3><div>Retrospective review of vascular ring interventions at the Hospital Universitario 12 de Octubre in Madrid, between January 2014 and March 2023, and analysis of the literature.</div></div><div><h3>Results</h3><div>Between January 2014 and March 2023, a total of 31 patients were operated on without any deaths being recorded. In 67.7% of cases the approach was thoracoscopic, and prenatal diagnosis was performed in 82.7% of susceptible cases.</div></div><div><h3>Conclusions</h3><div>Early surgery is considered to avoid sequelae of this pathology, without significant differences in surgical complications or associated with the type of approach, thoracoscopic or thoracotomy/sternotomy.</div><div>They meet the criteria for surgical indication: patients with symptomatic vascular rings when they first appear, asymptomatic complete vascular rings with a decrease in the airway lumen ≥ 50% in dynamic imaging tests, and all elective double aortic arches around 6 months of age, regardless of clinical symptoms and degree of airway compression.</div></div>\",\"PeriodicalId\":42671,\"journal\":{\"name\":\"Cirugia Cardiovascular\",\"volume\":\"32 5\",\"pages\":\"Pages 244-252\"},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cirugia Cardiovascular\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1134009624001268\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cirugia Cardiovascular","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1134009624001268","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
Cirugía del anillo vascular: ¿cuándo intervenir? Revisión de nuestra casuística y presentación de un algoritmo de manejo
Introduction and objectives
The term vascular ring encompasses different anatomical variants, the result of anomalous embryonic development of the primitive aortic arches, with the potential to cause injuries to the airway and/or digestive tract. Despite a more frequent, early and/or prenatal diagnosis, there are no clear management recommendations in clinical guidelines.
We present the management algorithm of this center, supported by the literature and a review of the results of patients operated on there.
Methods
Retrospective review of vascular ring interventions at the Hospital Universitario 12 de Octubre in Madrid, between January 2014 and March 2023, and analysis of the literature.
Results
Between January 2014 and March 2023, a total of 31 patients were operated on without any deaths being recorded. In 67.7% of cases the approach was thoracoscopic, and prenatal diagnosis was performed in 82.7% of susceptible cases.
Conclusions
Early surgery is considered to avoid sequelae of this pathology, without significant differences in surgical complications or associated with the type of approach, thoracoscopic or thoracotomy/sternotomy.
They meet the criteria for surgical indication: patients with symptomatic vascular rings when they first appear, asymptomatic complete vascular rings with a decrease in the airway lumen ≥ 50% in dynamic imaging tests, and all elective double aortic arches around 6 months of age, regardless of clinical symptoms and degree of airway compression.