FOLLOW-UP OF SURGICAL-CORRECTION OF VASCULAR ANOMALIES CAUSING TRACHEOBRONCHIAL COMPRESSION

Between January 1977 and January 1990, 44 patients with symptomatic va scular rings/slings required surgical intervention at this center. Nin eteen patients had double aortic arch (group I); 13 patients had vascu lar ring consisting of right aortic arch, anomalous origin of the left subclavian artery, and ligamentum arteriosus (group II); eight patien ts had innominate artery compression (group III); and four patients ha d pulmonary artery sling (group IV). Three patients had complex congen ital heart defect and died secondary to it and are excluded from the s tudy. Follow-up was obtained on 31 patients (76%). The follow-up perio d ranged from 0.4 years to 10.9 years, with a mean of 3.6 years. Seven ty percent of the overall group were asymptomatic, and 30% of patients continued to have upper and lower respiratory symptoms on late follow -up. One third of patients in groups I and II, who underwent surgical repair, continue to have symptoms. Patients who have persistent sympto ms should be further evaluated with PFTs, MRI, and bronchoscopy, and m ay benefit from aortopexy. Patients with innominate artery compression and pulmonary artery sling do well soon after surgery with relief of most of their symptoms.