test 5 vascular rings double aortic arch

Question 1

Vascular Rings Double Aortic Arch

Answer 1

• Trachea and esophagus are encircled by vascular structures
• Right arch (posterior)
        ▫ Right common carotid
        ▫ Right subclavian
• Left aortic arch (anterior)
        ▫ Left common carotid
        ▫ Left subclavian

Question 2

Vascular Rings Double Aortic Arch Surgical Correction

Answer 2

• Surgical division of the vascular ring is indicated in any patient with symptoms of airway or esophageal compression and in patients undergoing surgery for repair of associated cardiovascular or thoracic anomalies
• The chest is entered between the fourth and fifth rib ( left thoracotomy)
• Upon dissecting the arches off the trachea and esophagus, the arches can be divided. After division the two aortic ends are over sewn with 2 running layers of non-absorbable sutures
• Additional relief can be obtained by stitching the lateral wall of the aorta to the adjacent rib to pull it away from the esophagus.

Question 3

Right Arch W/ left PDA Repair

Answer 3

SA = Subclavian artery
KD = Kommerrell’s diverticulum* -> blind tube leading from a cavity or passage
LA = Ligamentum Arteriosum

Question 4

CPB considerations with a Right Arch W/ left PDA Repair

Answer 4

• Incision: left lateral thoracotomy

* CPB: Off pump