Vascular rings and pulmonary slings

Development of the mediastinal great vessels is the result of the growth and resorption of vessels derived from the two dorsal aortae and all the derived arches (Fig. 18.1). An alteration in the process that originates the great vessels can result in the development of a complete ring surrounding the trachea and esophagus. Depending on the type of alteration, several anatomical variants are possible, all causing an obstruction at respiratory and esophageal levels. The indication for corrective surgery to relieve the obstructive symptoms is a consequence of their tendency to constrict the trachea and/or esophagus [1]. Vascular rings comprise an estimated 1% of cardiovascular malformations that are managed surgically.