RESUMEN
Described herein is a clinical case report concerning successful elimination of symptoms of oesophageal compression and the tracheobronchial tree in an adult female patient presenting with an incomplete vascular ring and the right-sided aortic arch with mirror-image branching of vessels.
Asunto(s)
Aorta Torácica , Descompresión Quirúrgica/métodos , Esófago/diagnóstico por imagen , Tráquea , Anillo Vascular , Procedimientos Quirúrgicos Vasculares/métodos , Adulto , Aorta Torácica/anomalías , Aorta Torácica/diagnóstico por imagen , Ecocardiografía/métodos , Esófago/fisiopatología , Femenino , Humanos , Cuidados Posoperatorios/métodos , Tomografía Computarizada Espiral/métodos , Tráquea/diagnóstico por imagen , Tráquea/fisiopatología , Resultado del Tratamiento , Anillo Vascular/diagnóstico , Anillo Vascular/fisiopatología , Anillo Vascular/cirugíaRESUMEN
BACKGROUND: Chronic tracheal obstruction has been associated with learning deficits; hence, early surgical intervention has been suggested. AIM: To evaluate the relationship between learning performance and vascular ring caused by an isolated aberrant right subclavian artery. METHODS: Participants included 1,685 undergraduate students (ie, students of medical informatics and medical/public health students) in Central Taiwan. The diagnostic period was from 2005 to 2010. Vascular ring was diagnosed by two-dimensional echocardiographic screening and was validated by esophagogram. The reference group (medical students) was associated with higher learning performance, whereas the comparison group (students of medical informatics and public health) was associated with lower learning performance. Multiple logistic regression was used for analysis. RESULTS: The prevalence of vascular ring among the reference and comparison groups was 0.48 and 2.03%, respectively. The odds ratio for the vascular ring was 4.90 (95% confidence interval: 1.30-18.40) after adjusting for potential confounders. CONCLUSIONS: This study suggests that vascular ring can impact learning efficiency and advocates for larger dedicated studies. © 2017 The Authors Journal of Clinical Ultrasound Published by Wiley Periodicals, Inc. J Clin Ultrasound 45:556-560, 2017.
Asunto(s)
Ecocardiografía/métodos , Aprendizaje , Estudiantes/estadística & datos numéricos , Anillo Vascular/diagnóstico por imagen , Anillo Vascular/fisiopatología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Estudiantes de Medicina , TaiwánAsunto(s)
Azitromicina/administración & dosificación , Anomalías Cardiovasculares , Trastornos de Deglución , Infecciones por Mycoplasma , Prednisona/administración & dosificación , Arteria Subclavia/anomalías , Anillo Vascular , Antibacterianos/administración & dosificación , Anomalías Cardiovasculares/diagnóstico , Anomalías Cardiovasculares/fisiopatología , Niño , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Trastornos de Deglución/fisiopatología , Trastornos de Deglución/terapia , Diagnóstico Diferencial , Ecocardiografía/métodos , Endoscopía del Sistema Digestivo/métodos , Esofagitis/diagnóstico , Esofagitis/etiología , Esofagitis/fisiopatología , Esofagitis/terapia , Hemorragia Gastrointestinal/diagnóstico por imagen , Hemorragia Gastrointestinal/etiología , Glucocorticoides/administración & dosificación , Humanos , Masculino , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/tratamiento farmacológico , Infecciones por Mycoplasma/fisiopatología , Mycoplasma pneumoniae/aislamiento & purificación , Recurrencia , Arteria Subclavia/fisiopatología , Resultado del Tratamiento , Anillo Vascular/diagnóstico , Anillo Vascular/fisiopatologíaRESUMEN
Vascular rings are rare anomalies that occur as a result of abnormal development of the aortic arch complex, often manifested by signs of tracheo-oesophageal compression during the infant period. A double aortic arch anomaly is the most common type of vascular ring pathology. Here we report a case presenting with wheezing and stridor in a 10-month-old child.
Asunto(s)
Ruidos Respiratorios/fisiopatología , Anillo Vascular/fisiopatología , Aorta Torácica/anomalías , Aorta Torácica/fisiopatología , Humanos , Lactante , Masculino , Anillo Vascular/diagnóstico , Anillo Vascular/patologíaRESUMEN
Clinically, early diagnosis and treatment is important for survival of pediatric with vascular ring (VR) associated with congenital heart disease (CHD), and accurate evaluation of VR is a prerequisite for repair surgical. The study aimed to assess the quantitative characteristics of tracheal compression in pediatrics with VR and CHD using dual-source computed tomography (DSCT), and further provided effective information for surgical decisions. A total of 49 VR patients with CHD and 56 controls were enrolled. The tracheal quantitative measurements (short diameter, long diameter, tracheal area and tracheal length) were obtained, and the degree of tracheal compression was assessed. Our results indicated that VR associated with CHD may cause more serious and complex symptoms, and the greater tracheal compression were found on DSCT when more severe symptoms were present (r = 0.84). The degree of tracheal compression was significantly different within the VR group between those with and without surgery (P = 0.002). Finally, there were good agreement among (1-long diameter ratio), (1-short diameter ratio) and (1-area ratio) in patients and controls, respectively. This study indicated that DSCT enables provides accurate quantitative tracheal compression information for VR pediatrics associated with CHD, and evaluation of the degree of tracheal compression by 1-area ratio may contribute to the repair surgical of VR.
Asunto(s)
Cardiopatías Congénitas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Tráquea/diagnóstico por imagen , Estenosis Traqueal/diagnóstico por imagen , Preescolar , Femenino , Cardiopatías Congénitas/fisiopatología , Cardiopatías Congénitas/cirugía , Humanos , Lactante , Masculino , Pediatría , Estudios Retrospectivos , Tráquea/fisiopatología , Tráquea/cirugía , Estenosis Traqueal/fisiopatología , Estenosis Traqueal/cirugía , Anillo Vascular/diagnóstico por imagen , Anillo Vascular/fisiopatologíaRESUMEN
A male neonate presented with CHARGE syndrome, a multiorgan genetic disorder involving the Coloboma of the eyes, congenital Heart defects, nasal choanal Atresia, growth and development Retardation, Genitourinary disorders, and Ear anomalies and deafness. Moreover, he had a rare case of vascular ring-consisting of a right aortic arch with retroesophageal brachiocephalic artery-combined with coarctation of the mid-aortic arch. He underwent both vascular ring and aortic arch repair at our institution. To our knowledge, this is the 4th documented case of this exceedingly rare type of aortic arch anomaly combined with aortic arch obstruction. Moreover, it is the first confirmed case of these combined disorders occurring in CHARGE syndrome. This report describes a truly rare case and reveals the limitations of echocardiography in detecting complex aortic arch anomalies while illustrating the benefits of advanced imaging prior to surgical intervention.