{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:18:47Z","timestamp":1792037927143,"version":"4.4.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asian Cardiovasc Thorac Ann"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vascular rings are aortic arch anomalies with a spectrum of manifestations ranging from asymptomatic lesions detected incidentally to an acute presentation secondary to tracheo-esophageal compression. Circumflex retro-esophageal aortic arch is an extreme form of true vascular ring. It remains an uncharted territory to many surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of peer reviewed journals was completed based on the key words, \u201cCircumflex aorta,\u201d \u201cCircumflex retro-esophageal aorta\u201d and \u201ccircumflex arch\u201d using Google scholar, Scholars Portal Journals and PubMed. The reference section for each article found was searched to obtain additional articles. Literature on the circumflex aorta was reviewed starting from the embryogenesis to the latest management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Right circumflex aorta is more prevalent compared to left circumflex aorta. It can occur in isolation or in association with other intracardiac lesions. Mainly presents in children, however reported in adults too. The presentation may vary from asymptomatic lesion to acute respiratory distress secondary to airway compression. Computerized tomography (CT) and magnetic resonance imaging (MRI) are important tools in delineating the vascular anatomy. Aortic uncrossing is the definitive procedure. However, the role of concomitant tracheobronchopexy is emerging. Native tissue-to-tissue anastomosis is commonly preferred, but cases of extra-anatomic grafts are reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Circumflex aorta is amenable to complete repair. Preoperative delineation of anatomy is important for successful surgical outcome. Division of the retro-esophageal segment is crucial in relieving the compressive symptoms. In addition, tracheobronchopexy is helpful in addressing residual tracheomalacia but this accounts for a high-risk surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02184923211015092","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T03:26:23Z","timestamp":1620530783000},"page":"217-225","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Circumflex aorta: An uncharted territory"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2081-6723","authenticated-orcid":false,"given":"Maruti","family":"Haranal","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, National Heart Institute, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balaji","family":"Srimurugan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery, Amrita Institute of Medical Sciences, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivakumar","family":"Sivalingam","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, National Heart Institute, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"bibr1-02184923211015092","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.15.02063"},{"key":"bibr2-02184923211015092","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2017160033"},{"key":"bibr3-02184923211015092","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)35662-0"},{"key":"bibr4-02184923211015092","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-980040"},{"key":"bibr5-02184923211015092","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM194511152332003"},{"key":"bibr6-02184923211015092","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1136\/hrt.28.6.722","volume":"28","author":"D\u2019Cruz IA","year":"1966","journal-title":"Br Heart J"},{"key":"bibr7-02184923211015092","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.50.5.1047"},{"key":"bibr8-02184923211015092","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951100009136"},{"key":"bibr9-02184923211015092","unstructured":"Allen HD, Driscoll DJ, Shaddy RE, et\u00a0al. Aortic arch anomalies. In: Allen H (ed.),\n                      Moss and Adams\u2019 heart disease in infants, children and adolescents: including the fetus and young adults\n                      . 7th ed., vol I., sect VII, chap 36. 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