Blood vessel malformation forming a 'ring' constricting the airway of a 9-month-old child

Recently, Nghe An Obstetrics and Pediatrics Hospital received patient NTQ (9 months old, in Quy Hop district) with respiratory failure and severe pneumonia. Through examination, echocardiography, and chest CT scan, doctors discovered that this baby boy had a vascular ring defect due to a double aortic arch. This vascular ring acts like a ring that clamps the trachea and esophagus, causing compression, causing the baby to have prolonged wheezing, severe pneumonia, and tracheal stenosis.

After examination and consultation, the doctors determined that this was a very rare and difficult case, with a poor prognosis, requiring surgery to create a double aortic arch for the child, which would be life-threatening if not treated promptly. Surgery to create a double aortic arch is a very complicated technique, especially for young children. The surgical process requires a very high level of precision, otherwise it is very easy to damage the patient's aorta.

For this patient, the surgical team performed a vascular ring cut, cut the left branch of the artery right behind the right subclavian artery, sutured both ends, and released the compression on the patient's trachea and esophagus... The surgery was very successful. Intraoperative tracheal endoscopy showed that the tracheal stenosis due to the double aortic arch was wider than before.

However, because the patient had a long-standing stenosis of the trachea, combined with a soft tracheal cartilage condition, post-operative care at the Department of Surgical Intensive Care encountered many difficulties, requiring a lot of care, thoughtfulness, and meticulousness. During the treatment, the patient was challenged to wean off the ventilator many times, closely monitored each wheezing episode, cared for each feeding, and bathed daily.

After more than 60 days of resuscitation at the department, this child was discharged from the hospital and returned home in stable condition./.