Progress in Pediatric Cardiology

Volume 53, June 2019, Pages 42-46

© 2018 Elsevier B.V.


Received 27 August 2018, Revised 29 October 2018, Accepted 30 October 2018, Available online 15 January 2019


Vascular rings and slings: Contemporary observations.



William N Evans, MD, Ruben J Acherman, MD, Michael L Ciccolo, MD, Dean Berthoty, MD, Gary A Mayman, MD, Humberto Restrepo, MD, MPH




Children’s Heart Center Nevada, 3006 S Maryland Pkwy, Ste 690, Las Vegas, NV 89109, USA.




We reviewed our recent experience with vascular rings and slings, including observations from diagnostic imaging and surgery. We analyzed data from all patients diagnosed with a vascular ring or sling between September 2015 and August 2018. Our definition of vascular rings or slings did not include a left aortic arch with an aberrant right subclavian artery, accompanied by a left ductus arteriosus or ligamentum. We identified 74 patients for analysis. Of the 74, 45 (61%) had a right aortic arch with aberrant left subclavian artery and left-sided ductus arteriosus or ligamentum, 14 (19%) had a right aortic arch with a left-sided ductus or ligamentum and a normal left subclavian artery, 11 (15%) had a double aortic arch, 2 (3%) had a pulmonary artery sling, and 2 (3%) had a left aortic arch with aberrant right subclavian artery and a right-sided ductus arteriosus or ligamentum. Of the 74 patients, 40 (54%) were born in Nevada between January 2017 and August 2018. Of these 40, 33 (83%) were diagnosed prenatally. For the period January 2017 to August 2018, there were approximately 54,000 live births in Nevada. For right aortic arch versus double aortic vascular rings, 31 had a right aortic arch vascular ring for a prevalence of 5.7 per 10,000 live births, and 6 had a double aortic arch vascular ring for a prevalence of 1.1 per 10,000 live births (p=0.0001). Vascular rings are common congenital cardiovascular malformations, especially right aortic arch vascular rings. Further, a high percentage of vascular rings can be detected prenatally.


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