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Trends in vascular ring surgery

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Presentation on theme: "Trends in vascular ring surgery"— Presentation transcript:

1 Trends in vascular ring surgery
Carl L. Backer, MD, Constantine Mavroudis, MD, Cynthia K. Rigsby, MD, Lauren D. Holinger, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 129, Issue 6, Pages (June 2005) DOI: /j.jtcvs Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Vascular ring patient population, 1946–2004. Arrows indicate prior major publications from Children’s Memorial Hospital. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 The anatomy of a patient with a right aortic arch, retroesophageal left subclavian artery, and large Kommerell diverticulum. The ligamentum is not illustrated. The Kommerell diverticulum is an embryologic remnant of the left fourth aortic arch. The diameter of the Kommerell diverticulum is usually equal to the size of the descending aorta. LCA, Left carotid artery; RCA, right carotid artery; LSA, left subclavian artery; RSA, right subclavian artery. Reprinted with permission of the artist, R. F. Idriss. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Resection of a Kommerell diverticulum through a left thoracotomy. There is a vascular clamp partially occluding the descending thoracic aorta at the origin of the Kommerell diverticulum. The clamp on the left subclavian artery is not illustrated. The Kommerell diverticulum has been completely resected. LCA, Left carotid artery; RCA, right carotid artery; LSA, left subclavian artery; RSA, right subclavian artery. Reprinted with permission of the artist, R. F. Idriss. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 The completed repair. The orifice at which the Kommerell diverticulum was resected is usually closed primarily, or as shown in the inset, the orifice can be patched with polytetrafluoroethylene if necessary. The left subclavian artery has been implanted into the side of the left common carotid artery with fine running polypropylene sutures. LCA, Left carotid artery; RCA, right carotid artery; LSA, left subclavian artery; RSA, right subclavian artery. Reprinted with permission of the artist, R. F. Idriss. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

6 Figure 5 Mean postoperative length of stay after vascular ring surgery. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

7 Figure 6 Diagnostic imaging techniques for the preoperative evaluation of vascular rings. There has been a dramatic shift from barium swallow and angiography to CT and MRI. There has also been an increase in the number of patients having preoperative or intraoperative bronchoscopy. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

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