{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:56:07Z","timestamp":1790812567762,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:00:00Z","timestamp":1684713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>There has been a rise in the prenatal detection of right sided aortic arch (RAA). When associated with a left\u2010sided arterial duct (LD), this forms a vascular ring encircling the trachea. Infants may have symptoms or signs suggestive of tracheoesophageal compression but many are asymptomatic. The objective of this study was to investigate the relationship between symptoms and severity of tracheobronchial compression assessed by bronchoscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review of all cases of prenatally diagnosed RAA\u2010LD in the absence of associated congenital heart disease at Evelina London Children's Hospital and Kings College Hospital over a 4\u2010year period between April 2015\u22122019. Clinical records, fetal echocardiograms, and free\u2010breathing flexible bronchoscopy (FB) data were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred and twelve cases of isolated RAA\u2010LD were identified of whom 82 cases (73%) underwent FB. FB was performed median age of 11 months (range 1\u221236 months), no complications occurred. Aberrant left subclavian artery (ALSA) was present in 86% (96\/112) and mirror image branching (MIB) in 13% (15\/112). 34\/112 (30%) reported symptoms during follow\u2010up. 36\/77 (47%) with ALSA who underwent FB showed moderate\u2010severe compression mostly at distal tracheal and carinal level of whom 38% had parent\u2010reported symptoms. Moderate\u2010severe compression was seen in 3\/5 (60%) with MIB mostly at mid tracheal level; 3 were symptomatic but only 2 had tracheal compression. In total 36% (18\/50) of investigated asymptomatic patients showed moderate\u2010severe compression. Respiratory symptoms were poorly predictive of moderate\u2010severe tracheal compression (positive predictive value 66%, negative predictive value 64%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The absence of symptoms did not exclude significant tracheal compression. The anatomical effect of the vascular ring is under appreciated when symptoms alone are used as a marker of tracheal compression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.26463","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T08:20:29Z","timestamp":1684743629000},"page":"2275-2282","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact on the trachea in children with prenatally diagnosed vascular ring formed by a right aortic arch"],"prefix":"10.1002","volume":"58","author":[{"given":"Christopher","family":"Oakley","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Disease Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"},{"name":"Harris Birthright Centre, Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Hurn","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"},{"name":"Harris Birthright Centre, Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Suckling","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"},{"name":"Harris Birthright Centre, Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Moriarty","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"},{"name":"Harris Birthright Centre, Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"},{"name":"Harris Birthright Centre, Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Turcu","sequence":"additional","affiliation":[{"name":"Paediatric Respiratory Unit, Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Heraghty","sequence":"additional","affiliation":[{"name":"Paediatric Respiratory Unit, Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vita","family":"Zidere","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"},{"name":"Harris Birthright Centre, Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Nyman","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit, Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4084-4203","authenticated-orcid":false,"given":"Trisha V.","family":"Vigneswaran","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Evelina London Children's Hospital, Guy's &amp; St Thomas'\u00a0NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.11.1.124"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32490-5"},{"key":"e_1_2_10_4_1","unstructured":"Department of Health. Fetal anomaly screening programme. 2015. Accessed March 17 2022.\u00a0https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/990890\/NHS_fetal_anomaly_screening_programme__FASP__20-week_screening_scan_base_menu.odt"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1676413"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15805"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5388"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2023.02.058"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab527"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00382-2019"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1804-5"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/2150135116661279"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.02.030"},{"key":"e_1_2_10_14_1","article-title":"Morphology of vascular ring arch anomalies influences prognosis and management","author":"Ctori E","year":"2020","journal-title":"Arch Dis Child"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.10.044"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-318946"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.01.025"},{"issue":"2","key":"e_1_2_10_18_1","first-page":"234","article-title":"Long\u2010term outcomes of complete vascular ring division in children: a 36\u2010year experience from a single institution","volume":"24","author":"Naimo PS","year":"2017","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6104"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab225"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.pcsu.2014.01.001"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26463","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T04:46:17Z","timestamp":1702010777000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,22]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/ppul.26463"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26463","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.166870987.70826614\/v1","asserted-by":"object"}]},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,22]]},"assertion":[{"value":"2022-11-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}