{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:20:09Z","timestamp":1790011209289,"version":"4.0.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Our goal was to describe postoperative complications and outcomes in a large contemporary cohort of children with an isolated double aortic arch (DAA) or a right aortic arch (RAA) with left arterial ligament and to assess the impact of foetal diagnosis on outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We performed a retrospective analysis of all patients who underwent surgery for DAA or RAA with left arterial ligament between 2005 and 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 132 children were operated on for a DAA (n\u2009=\u200977) or a RAA (n\u2009=\u200955). Prenatal diagnosis was made in 100\/132 (75.8%). Median age at surgery for DAA was 5.0 (1.7\u201313.3) months and for RAA was 13.9 (6.4\u201320.1) months. There was no difference in the age at surgery between the prenatal and postnatal cases (8.6 [4.0\u201315.6] vs 5.4\u2009months [1.8\u201317.7]; P\u2009=\u20090.37). No surgical deaths occurred. Vocal cord palsy was the most common complication, occurring in 12\/132 (9%): of these, 11 resolved spontaneously and 1 required a temporary tracheostomy. Logistic regression demonstrated that older age at operation was the only predictor for a postoperative complication (P\u2009=\u20090.02). Overall, 21\/67 (31%) of prenatally detected, symptomatic cases reported residual symptoms\/signs 1\u2009year after surgery compared to 18\/28 (64%) of postnatally detected cases. Postnatal diagnosis was associated with persistent postoperative symptoms\/signs [P\u2009=\u20090.006, odds ratio\u2009=\u20093.9 (95% confidence interval 1.5\u20139.4)].<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Surgery to relieve a vascular ring resolves trache-oesophageal compressive symptoms in most cases, but parents\/patients should be aware that symptoms\/signs may persist in the first postoperative year despite effective release of the vascular ring. Earlier surgery and prenatal diagnosis may improve outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezab527","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T12:14:31Z","timestamp":1638360871000},"page":"1260-1268","source":"Crossref","is-referenced-by-count":15,"title":["Contemporary surgical outcome and symptomatic relief following vascular ring surgery in children: effect of prenatal diagnosis"],"prefix":"10.1093","volume":"61","author":[{"given":"Parinita","family":"Swarnkar","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital, Guy\u2019s & St Thomas\u2019 NHS Trust , London, UK"},{"name":"Guy\u2019s, King\u2019s & St Thomas\u2019 School of Medicine, King\u2019s College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Speggiorin","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital, Guy\u2019s & St Thomas\u2019 NHS Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B Conal","family":"Austin","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital, Guy\u2019s & St Thomas\u2019 NHS Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Nyman","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit, Evelina London Children\u2019s Hospital, Guy\u2019s & St Thomas\u2019 NHS Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caner","family":"Salih","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital, Guy\u2019s & St Thomas\u2019 NHS Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vita","family":"Zidere","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital, Guy\u2019s & St Thomas\u2019 NHS Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital, Guy\u2019s & St Thomas\u2019 NHS 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\u2019s Hospital, Guy\u2019s & St Thomas\u2019 NHS Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,12]]},"reference":[{"key":"2022053118485629700_ezab527-B1","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1161\/01.CIR.50.5.1047","article-title":"Right aortic arch: types and associated cardiac anomalies","volume":"50","author":"Knight","year":"1974","journal-title":"Circulation"},{"key":"2022053118485629700_ezab527-B2","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1080\/14767058.2019.1676413","article-title":"Prenatal incidence of isolated right aortic arch and double aortic arch","volume":"34","author":"Vigneswaran","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2022053118485629700_ezab527-B3","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1002\/pd.5388","article-title":"Prenatal diagnosis and clinical implications of an apparently isolated right aortic arch","volume":"38","author":"Vigneswaran","year":"2018","journal-title":"Prenat Diagn"},{"key":"2022053118485629700_ezab527-B4","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ppedcard.2018.10.006","article-title":"Vascular rings and slings: contemporary observations","volume":"53","author":"Evans","year":"2019","journal-title":"Progr Pediatr Cardiol"},{"key":"2022053118485629700_ezab527-B5","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/S0025-7125(16)35662-0","article-title":"Anomalies of the derivatives of the aortic arch system","volume":"32","author":"Edwards","year":"1948","journal-title":"Med Clin North Am"},{"key":"2022053118485629700_ezab527-B6","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1002\/uog.15805","article-title":"Fetuses with right aortic arch: a multicenter cohort study and meta-analysis","volume":"47","author":"D'Antonio","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2022053118485629700_ezab527-B7","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.jtcvs.2004.10.044","article-title":"Trends in vascular ring surgery","volume":"129","author":"Backer","year":"2005","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022053118485629700_ezab527-B8","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/BF00817607","article-title":"Follow-up of surgical correction of vascular anomalies causing tracheobronchial compression","volume":"15","author":"Anand","year":"1994","journal-title":"Pediatr Cardiol"},{"key":"2022053118485629700_ezab527-B9","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1093\/ejcts\/ezab225","article-title":"Right aortic arch forming a true vascular ring: a clinical review","volume":"60","author":"Biermann","year":"2021","journal-title":"Eur J Cardio-Thorac Surg"},{"key":"2022053118485629700_ezab527-B10","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s00246-017-1804-5","article-title":"Correlation of symptoms with bronchoscopic findings in children with a prenatal diagnosis of a right aortic arch and left arterial duct","volume":"39","author":"Vigneswaran","year":"2018","journal-title":"Pediatr Cardiol"},{"key":"2022053118485629700_ezab527-B11","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1136\/archdischild-2020-318946","article-title":"Postnatal impact of a prenatally diagnosed double aortic arch","volume":"106","author":"Vigneswaran","year":"2021","journal-title":"Arch Dis Child"},{"key":"2022053118485629700_ezab527-B12","article-title":"Influence of fetal diagnosis on management of vascular rings","author":"Stephens","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2022053118485629700_ezab527-B13","doi-asserted-by":"crossref","first-page":"e1336-41","DOI":"10.1542\/peds.2006-1097","article-title":"Management and outcomes of double aortic arch in 81 patients","volume":"118","author":"Alsenaidi","year":"2006","journal-title":"Pediatrics"},{"key":"2022053118485629700_ezab527-B14","first-page":"234","article-title":"Long-term outcomes of complete vascular ring division in children: a 36-year experience from a single institution","volume":"24","author":"Naimo","year":"2017","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2022053118485629700_ezab527-B15","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1111\/j.1651-2227.1999.tb00187.x","article-title":"Vascular rings: a rare cause of common respiratory symptoms","volume":"88","author":"Bakker","year":"2007","journal-title":"Acta Paediatrica"},{"key":"2022053118485629700_ezab527-B16","doi-asserted-by":"crossref","first-page":"e903-8","DOI":"10.1542\/peds.2005-1674","article-title":"Decade of experience with vascular rings at a single institution","volume":"117","author":"Humphrey","year":"2006","journal-title":"Pediatrics"},{"key":"2022053118485629700_ezab527-B17","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/021849230501300102","article-title":"Surgical repair of double aortic arch: 16-year experience","volume":"13","author":"Shanmugam","year":"2005","journal-title":"Asian Cardiovasc Thorac Ann"},{"key":"2022053118485629700_ezab527-B18","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s00431-017-2850-y","article-title":"Early and late outcomes after surgical management of congenital vascular rings","volume":"176","author":"Francois","year":"2017","journal-title":"Eur J Pediatr"},{"key":"2022053118485629700_ezab527-B19","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1177\/000313480507100403","article-title":"Video-assisted thoracoscopic division of vascular rings in pediatric patients","volume":"71","author":"Koontz","year":"2005","journal-title":"Am Surg"},{"key":"2022053118485629700_ezab527-B20","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1016\/j.jpedsurg.2008.11.062","article-title":"Follow-up of surgical correction of aortic arch anomalies causing tracheoesophageal compression: a 38-year single institution experience","volume":"44","author":"Ruzmetov","year":"2009","journal-title":"J Pediatr Surg"},{"key":"2022053118485629700_ezab527-B21","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.1540-8191.2009.00947.x","article-title":"Unusual manifestations of vascular rings","volume":"25","author":"Mainwaring","year":"2010","journal-title":"J Card Surg"},{"key":"2022053118485629700_ezab527-B22","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1016\/j.jpedsurg.2009.03.035","article-title":"Aortopexy for persistent tracheal obstruction after double aortic arch repair","volume":"44","author":"Fraga","year":"2009","journal-title":"J Pediatr Surg"},{"key":"2022053118485629700_ezab527-B23","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/0003-4975(92)90317-W","article-title":"Diagnosis and management of congenital vascular rings: a 22-year experience","volume":"53","author":"Chun","year":"1992","journal-title":"Ann Thorac Surg"},{"key":"2022053118485629700_ezab527-B24","first-page":"178","article-title":"A review of vascular rings 1980-1992","volume":"87","author":"Ledwith","year":"1994","journal-title":"Ir Med J"},{"key":"2022053118485629700_ezab527-B25","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1016\/j.athoracsur.2015.06.093","article-title":"Kommerell diverticulum should be removed in children with vascular ring and aberrant left subclavian artery","volume":"100","author":"Luciano","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2022053118485629700_ezab527-B26","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1007\/s00431-004-1607-6","article-title":"Vascular rings\u2013presentation, investigation and outcome","volume":"164","author":"Turner","year":"2005","journal-title":"Eur J Pediatr"},{"key":"2022053118485629700_ezab527-B27","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1002\/ppul.24490","article-title":"The long-term outcome of an isolated vascular ring\u2014a single-center experience","volume":"54","author":"Depypere","year":"2019","journal-title":"Pediatr Pulmonol"},{"key":"2022053118485629700_ezab527-B28","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpedsurg.2019.12.022","article-title":"Symptom persistence after vascular ring repair in children","author":"Callahan","year":"2020","journal-title":"Journal of Ped Surg Published online: January 29"},{"key":"2022053118485629700_ezab527-B29","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1002\/uog.22110","article-title":"Insights from fetal cardiac magnetic resonance imaging in double aortic arch","volume":"56","author":"van Poppel","year":"2020","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2022053118485629700_ezab527-B30","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.athoracsur.2019.01.062","article-title":"Double aortic arch with Kommerell diverticulum","volume":"108","author":"Backer","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2022053118485629700_ezab527-B31","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1016\/j.athoracsur.2012.05.101","article-title":"Primary resection of Kommerell diverticulum and left subclavian artery transfer","volume":"94","author":"Backer","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2022053118485629700_ezab527-B32","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/S0025-6196(12)60898-2","article-title":"Surgical treatment of vascular rings: the Mayo clinic experience","volume":"68","author":"Van Son","year":"1993","journal-title":"Mayo Clin Proc"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/61\/6\/1260\/43868474\/ezab527.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/61\/6\/1260\/43868474\/ezab527.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T21:13:19Z","timestamp":1673903599000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/61\/6\/1260\/6504028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,12]]},"references-count":32,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,1,12]]},"published-print":{"date-parts":[[2022,5,27]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezab527","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,6,1]]},"published":{"date-parts":[[2022,1,12]]}}}