prayers for Zipporrah and vascular rings

[Guest guest]

Darla,

I am so sorry to hear that Zipporrah is struggling with more sickness.

I will keep all of you, esp. Zipporrah, in my prayers.

the x-ray

revealed a trachea ring causing a narroing of her trachea. Something

about a possible vessel causing it to indent. It could explain a lot

of Zipporrah's breathing problems and other issues. I was wondering if

anyone else has had this or know about the issue?

The vessel and the narrowing of the trachea could be an aberrant

subclavian. Didn't Deb mention once that her had surgery to

correct his aberrant subclavian as an infant? I don't know if it has

been linked to mito though.

Take care and God Bless,

Indian Pediatr. 2003 Oct;40(10):951-7.

Vascular rings: an important cause of persistent

respiratory symptoms in infants and children.

Subramanyan R, Venugopalan P, Narayan R.

OBJECTIVE:

To study the pattern of symptomatic vascular rings in infants and

children with particular reference to clinical features, investigations

and management. SETTING: Tertiary Care Paediatric Cardiology Division

at the Royal Hospital, Muscat, Sultanate of Oman. DESIGN: Retrospective

study. METHODS: Data on all patients aged less than 13 years diagnosed

to have symptomatic vascular rings at the Royal Hospital, Muscat, Oman

from 1992 to 2001 were retrieved from hospital records. RESULTS:

Sixteen patients, 8 males and 8 females, aged 15 days to 36 months were

identified, and included 12 with double aortic arch and 4 with right

aortic arch, aberrant left subclavian artery and ligamentum arteriosum.

Associated intracardiac defects were not found in any. Noisy breathing

(7/16), stridor (6/16), respiratory distress (5/16) and recurrent

respiratory infections (5/16) were the common modes of presentation.

The duration from onset of symptoms to diagnosis ranged from 3 weeks to

24 months. Besides suggestive clinical features, the diagnosis was

suspected from the chest radiograph (presence of right aortic arch) in

7 patients and from 2-Dimensional echocardiography and Doppler studies

in 5 patients. Barium swallow studies, however, documented the abnormal

esophageal indentation in all the 16 patients. Confirmatory imaging

techniques included digital subtraction angiography in 7/16, cardiac

catheterization and angiography in 5/16, and CT and MRI of the chest in

2 each. All 16 patients underwent successful surgical repair, and 13/16

became asymptomatic. 3 patients continued to suffer from occasional

respiratory infections. CONCLUSIONS: A high index of clinical suspicion

coupled with the use of barium oesophagraphy enabled early diagnosis in

patients with symptomatic vascular rings, and surgical repair could be

performed successfully in all patients.

Wiad Lek. 2000;53(5-6):289-98

[Vascular rings as a cause of the respiratory

disturbances in children

Krzystolik-Ladzinska J, Wiecek-Wlodarska D, Guzikowski K, Rokicki W,

Wites M, Pieniazek P.

Kliniki Kardiologii Dzieciecej Slaskiej, Akademii Medycznej w

Katowicach.

Vascular

rings are an infrequent cause of tracheal and/or oesophageal

compression in infants and children. The authors present 11 cases of

vascular rings in children from 3 months to 15 years of age. There

were: double aortic arch in 5 cases, right aortic arch with left

arterial ligament in 1 case, aberrant right subclavian artery in 2

subjects and pulmonary artery sling in 3 patients. The diagnosis was

established on the basis of chest X-ray examination, echocardiographic

examination, bronchoscopy, angiography and magnetic resonance imaging.

Surgical correction was performed in all patients with good primary

results. As many as ten subjects were sent

to paediatric cardiology unit from pulmonary departments where for the

first time a suspicion of vascular ring existance was undertaken. All

of them were previously diagnosed and treated in paediatric hospitals,

usually as bronchial asthma. It is stressed that in every case of

unexplained chronic coughing it is necessary to perform at least

lateral X-ray examination of the chest with contrast in oesophagus.

Bildegebung 1994 Dec; 61 (4) 299-303

Diagnostic evaluation and surgical management of the

aberrant right subclavian artery.

Harms J, Vogel T, Ennker J, Felix R, Hetzer R.

A

case of dysphagia and dyspnea secondary to compression of the esophagus

and the trachea by an aberrant right subclavian artery is presented. As

the pathology of the aberrant right subclavian artery is extremely

diverse, the diagnosis without radiologic investigation is hardly

feasible. Conventional angiography of the aortic arch may be avoided by

3-dimensional magnetic resonance angiography, that is a suitable

noninvasive method to diagnose and visualize the vascular pathology and

the postoperative results after corrective vascular surgery. With the

use of a Gore-Tex prosthesis the right aberrant subclavian artery was

successfully translocated to the ascending aorta through a mid-sternal,

transmediastinal approach. In contrast to previous reports the

retro-esophageal vascular segment was kept in situ. The literature is

reviewed with the reference to the diagnostic procedure and the

treatment of dysphagia lusoria.