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Register a new userVascular Rings and the Aberrant Subclavian Artery 11 Cases Study
الحلقات الوعائية و شذوذ منشأ الشريان تحت الترقوة دراسة 11 حالة
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أحمد التكريتي( باحث )
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خلفية البحث و هدفه: تعد الحلقات الوعائية شذوذات خلقية نادرة المصادفة تحدث بمعدل أقل من 0,2 %. تُكتشف معظمها في مرحلة الطفولة. تحدث أعراض انضغاط جزئي أو كلي للمري و / أو الرغامى.قد تكون معزولة أو مترافقة مع تشوهات قلبية أخرى. نقدم دراسة لإحدى عشرة حالة صادفتنا منذ منتصف العام 2009 ، تم تدبيرها جراحياً بنجاح. نهدف إلى تبيان كيفية مقاربة هذه الحالات جراحياً و إيضاح المدخل الجراحي الأفضل. مواد البحث و طرائقه: تمتد الدراسة الاستعادية التي أجريت في مستشفى جراحة القلب الجامعي بدمشق بين عامي 2009 و 2010 . إِذ خضع 11 مريضاً شُخص لديهم حلقة وعائية لإصلاح جراحي . النتائج: راوحت أعمار المرضى بين 1.5 شهراً و 5 سنوات. مع توزع متساوٍ تقريباً في الجنسين. كانت الشكايات بمعظمها تنفسية. تباينت الحالات بين حلقة أبهرية مضاعفة و منشأ شاذ للشريان تحت الترقوة الأيمن و الأيسر. وجدت الآفات المرافقة بنسبة 54 %. لم يلاحظ حدوث اختلاطات بعد العمل الجراحي و خلال مدة المتابعة التي امتدت بين 7 و 10 أشهر. كما حدث تحسن ملحوظ و زوال للأعراض لدى المرضى بعد العمل الجراحي. الاستنتاج: بالمحصلة تقدم الجراحة إزالة ممتازة و طويلة الأمد للأعراض. و يعد التشخيص و الجراحة المبكران أمراً أساسياً في إنقاص العقابيل طويلة الأمد.
Background& Objective:Vascular rings are unusual rare congenital anomalies .Its incidence is less than 0.2%.Most of these defects are discovered early in infancy or childhood .They result in complete or partial encirclement of the trachea and/or esophagus .Some vascular rings are associated with other congenital heart defects, others may be isolated deficits. We present here eleven cases which we have encountered since the mid of 2009.These cases were managed surgically with good results .Through this study, we aim at demonstrating how to treat these cases surgically and to clarify the best approach for each case. Materials & Methods: A retrospective study at Damascus University Cardiac Surgery Hospital in the period between 2009 to 2010 was conducted.11 patients with diagnosed vascular rings underwent surgical repair. Results: Ages ranged between 1.5 months to 5 years with almost equal sex distribution. Most complaints were respiratory. Vascular rings include double aortic arche, aberrant left Subclavian artery and aberrant right Subclavian artery .Associated defects were in54% of cases. No complications were noticed postoperatively or in the follow up period which extended between 7 and10 months' .Remarkable relief and symptoms release were achieved postoperatively. Conclusion: Surgery affords excellent long-term resolution of symptoms. Early diagnosis and surgery are imperative to reduce the long-termsequels.
References used
Gross RE, Ware PF. The surgical significance of aortic arch anomalies. Surg Gynecol Obstet 1946;83:435
Edwards JE. Anomalies of derivatives of aortic arch system. Med Clin North Am 1948;32:925–49
McLaughlin RB Jr, Wetmore RF, Tavill MA, Gaynor JW, Spray TL. Vascular anomalies causing symptomatic tracheobronchial compression. Laryngoscope 1999;109:312–9
Jaffe RB. Radiographic manifestations of congenital anomalies of the aortic arch. Radiol Clin North Am 1991;29:319–34
Fleenor JT, Weinberg PM, Kramer SS, Fogel M. Vascular rings and their effect on tracheal geometry. Pediatr Cardiol 2003;24:430–5
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New results were obtained including necessary and sufficient condition
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