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Vascular Rings Program

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Vascular ring describes an unusual formation of the aorta and the blood vessels around it. Children are diagnosed with vascular rings when their trachea (the tube that carries air to the lungs) and their esophagus (the tube that carries food to the stomach) are circled by a ring of blood vessels. Typically, the ring puts pressure on the trachea and esophagus, which can make it hard to breathe or eat.

The age at which a vascular ring is diagnosed now spans from prenatal life to adulthood. Patients with vascular rings may be school-aged children, teenagers, or adults before they are diagnosed with a vascular ring after having spent years with difficulty swallowing while eating or having an odd, barky cough. 

Alternatively, some infants have difficulty breathing at birth and may need to be intubated (have a breathing tube inserted) in order to bring air to the lungs. Symptoms vary due to the degree that the trachea (airway) and esophagus (tube carrying food to the stomach) are narrowed by the vessel pressing on them. Increasingly, a vascular ring may be diagnosed pre-natally during a fetal echocardiogram. During this test, heart vessels are scanned for their placement in relation to the airway and esophagus.

Vascular rings are diagnosed several different ways. However, all patients require a CT or MRI evaluation of the chest and, in addition, a bronchoscopic exam by an Otolaryngology (ENT) specialist

These patients also receive an echocardiogram of the heart to assess the vessels and determine whether there are any associated heart defects. Typically, these studies can be accomplished within one day. All patients are evaluated by a multidisciplinary team which includes Otolaryngology, Medical Imaging and Cardiology.


The Lurie Children's Difference

Led by Dr. Osama Eltayeb, Lurie Children's Vascular Ring Program treats children with severe vascular rings, using innovative and proven surgical methods to relieve pressure on the trachea and esophagus. Our center has one of the largest published surgical experiences with vascular ring; currently, we have operated on more than 500 patients.

Lurie Children’s surgeons first operated on a patient with a vascular ring in 1946. In the following 75 years they pioneered a number of procedures to advance the methods used to correct many different kinds of vascular rings. Our surgeons, in 1953, were the first in the world to successfully repair a pulmonary artery sling, and continue to operate on more pulmonary artery slings than any other hospital in North America. We have pioneered procedures such as Kommerell’s diverticulum excision, along with division of an associated vascular ring, to prevent enlargement of the diverticulum over time with recurrence of symptoms of obstructed breathing or difficulty swallowing.

The results of vascular ring surgery are excellent – we have not had an operative mortality in the past 30 years and more than 90% of our patients see their symptoms resolve.

Conditions We Treat

Our team treats the following types of vascular rings:

  • Double aortic arch – instead of one aorta which leaves the body and arches leftward away from the heart, a patient with this type of vascular ring has a second branch that arches rightward; these two arch branches encircle the trachea and esophagus. 
  • Pulmonary artery sling – the pulmonary artery has two main branches, right and left, which usually sit in front of the trachea and esophagus; in this type of vascular ring the left pulmonary artery circles around behind the trachea and traps the trachea between the aorta rising from the heart and the left pulmonary artery. 
  • Right aortic arch and left ligamentum – some infants are born with an aorta which arches right instead of the usual left arching; in some of these patients, a vascular ring forms when the ligamentum, which is a cord-like remainder of what was in fetal life and early infancy an arterial connection, creates a circle with the right arch around the trachea. 

Our Specialists

The three Lurie Children’s Heart Center attending surgeons are American Board of Thoracic Surgery-certified Thoracic and Congenital Cardiac Surgeons. They have expertise in all aspects of surgery for repair of vascular rings.

Cardiothoracic Surgeons

Osama M. Eltayeb, MD

Director, Vascular Rings Program; Director, Tracheal Reconstruction Program; Attending Physician, Cardiovascular-thoracic Surgery; Member, Lurie Children's Surgical Foundation

Associate Professor of Surgery (Cardiac Surgery), Northwestern University Feinberg School of Medicine

Call 312.227.4240

Sunjay Kaushal, MD, PhD

Division Head, Cardiovascular-Thoracic Surgery; A.C. Buehler Professorship in Surgery; Member, Lurie Children's Surgical Foundation

Professor of Surgery, Northwestern University Feinberg School of Medicine

Call 312.227.4240

Michael C. Mongé, MD

Surgical Director, Heart Failure/Heart Transplant Program; Attending Physician, Cardiovascular-Thoracic Surgery; Member, Lurie Children's Surgical Foundation

Assistant Professor of Surgery (Cardiac Surgery), Northwestern University Feinberg School of Medicine

Call 312.227.4240

Otolaryngologists (ENT) Surgeons

Dana M. Thompson, MD, MS, MBA, FACS

Division Head, Otorhinolaryngology-Head & Neck Surgery; Lauren D. Holinger, MD Professorship in Pediatric Otolaryngology; Vice Chair Ambulatory Practice, Department of Surgery; Executive Physician Director, Ambulatory Practice; Member, Lurie Children's Surgical Foundation

Professor of Otolaryngology – Head & Neck Surgery, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Kathleen R. Billings, MD, FACS, FAAP

Attending Physician, Otorhinolaryngology-Head & Neck Surgery; Director of Clinical Practice; Member, Lurie Children's Surgical Foundation

Associate Professor of Clinical Otolaryngology-Head and Neck, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Saied Ghadersohi, MD

Attending Physician, Otorhinolaryngology-Head & Neck Surgery; Resident Education Site Director

Assistant Professor of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Jonathan B. Ida, MD, MBA, FACS, FAAP

Attending Physician, Otorhinolaryngology-Head & Neck Surgery; Vice Chair of Procedural Services, Department of Surgery; Member, Lurie Children's Surgical Foundation

Assistant Professor of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

John Maddalozzo, MD, FACS, FAAP

Head, Section of Advanced Head and Neck Surgery; Attending Physician, Otorhinolaryngology-Head & Neck Surgery; Member, Lurie Children's Surgical Foundation

Professor of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Jeff C. Rastatter, MD, MS, FACS, FAAP

Attending Physician, Otorhinolaryngology-Head & Neck Surgery; Director of Patient Experience; Co-Director of Skull Base Surgery; Member, Lurie Children's Surgical Foundation

Associate Professor of Otolaryngology (Pediatric Otolaryngology), Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Taher Valika, MD

Attending Physician, Otorhinolaryngology-Head & Neck Surgery; Medical Director, Aerodigestive Program; Director; Upper Airway Surgery; Member, Lurie Children's Surgical Foundation

Assistant Professor of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

What to Expect

The diagnosis of vascular rings can occur in several different ways. However, all patients require a CT or MRI evaluation of the chest and, in addition, a bronchoscopic exam by one of our ENT colleagues. These patients also receive an echocardiogram of the heart. Typically, these studies can be accomplished within one day. All patients are evaluated by a multidisciplinary team including Ear-Nose-Throat physiciansMedical Imaging and Cardiology.

The vascular rings that are repaired through a left thoracotomy usually entail a two-day hospital stay for the simpler vascular rings and a five-day hospital stay for the more extensive procedures. Patients undergoing pulmonary artery sling repair are operated on through a median sternotomy, with the use of cardiopulmonary bypass. The average length of stay for these patients is five to seven days.

The results of vascular ring surgery are excellent – we haven’t had operative mortality in the past 30 years and more than 90% of our patients see their symptoms resolve.

Appointments

If you'd like to schedule an appointment with one of our specialists, call 1.800.543.7362 (1.800.KIDS.DOC®) or visit our Appointments page for more information.

In addition to in-person visits, we now offer telemedicine visits via video or phone. Some appointments will still require you to be seen in-person, but your physician and care team will let you know if a telemedicine appointment is available.

Second Opinions

For families or providers seeking a second opinion, we offer a Priority Second Opinion Clinic.

Request a Second Opinion

Heart Center Family Resource Guide

To help prepare families for their care with Lurie Children's Heart Center, we have compiled a list of resources about treatment and recovery. Learn how to get ready for an inpatient stay or outpatient visit, and read about our support services for patients and families.

Related Specialties

Conditions We Treat