AORTIC VASCULAR RINGS ENCOUNTERED IN THE SURGICAL TREATMENT OF CONGENITAL PULMONIC STENOSIS

Abstract

Variations of a vascular ring due to anomalies of the aortic arch encountered in the surgi. cal treatment of patients with congenital pulmonic stenosis are descr. The diagnosis of a retro-esophageal artery can usually be made by X-ray with barium swallow. The anomalous vessel causes an abnormal indentation in the posterior wall of the esophagus seen in the customary oblique and lateral projection. It is important to recognize the presence of a retro-esophageal subclavian artery at the time of operation for pulmonic stenosis, and appreciate that it may be used in creating an artificial ductus arteriosus. Angiocardiography may demonstrate the anomalous vessel, but this diagnostic aid is generally of little help. It has been of great value in demonstrating the side of the aortic arch in several unusual patients. 3 cases of double aortic arch are descr. Marked respiratory difficulty as a result of tracheal constriction was present in only 1 of these patients and was corrected by division of the smaller of the 2 arches.