COMPRESSION OF THE TRACHEA OR ESOPHAGUS VASCULAR ANOMALIES

PEDIATRICS ◽  
1951 ◽  
Vol 7 (1) ◽  
pp. 69-88
Author(s):  
ROBERT E. GROSS ◽  
EDWARD B.D. NEUHAUSER
Keyword(s):  
Aortic Arch ◽  
Vascular System ◽  
Vascular Malformations ◽  
Pulmonary Ventilation ◽  
Innominate Artery ◽  
Vascular Anomaly ◽  
Vascular Anomalies ◽  
Ligamentum Arteriosum ◽  
Superior Mediastinum ◽  
Clear Idea

Description is given of five different types of anomalies of the great vessels in the superior mediastinum which can produce compression of the esophagus or trachea (or both). These malformations of the vascular system can give rise to difficulties in swallowing and to serious disturbances in pulmonary ventilation. These anomalies include double aortic arch, right aortic arch with a left ligamentum arteriosum, anomalous innominate artery, anomalous left common carotid artery, and an aberrant subclavian artery. The various symptom complexes which can be found with these anomalies are described. Endoscopic visualization of the interior of the esophagus or trachea gives valuable information in some cases. The investigation of these subjects should include fluoroscopic and film studies of the esophagus and trachea by contrast media. Data gathered from such roentgenologic examinations usually give a fairly clear idea of the type of vascular anomaly which is present. It is possible to attack surgically each of these vascular malformations. In general, the esophagus or trachea can be relieved by division of an anomalous vessel or by displacement of an artery in such a manner that it is carried away from the compressed structure. When necessary, these operative procedures can be undertaken in very young babies, even in the presence of a high degree of respiratory obstruction. All the operations have been through a left anterolateral, transpleural approach, under general anesthesia with a closed system. The results of operation in 40 patients are analyzed. It is evident that many vascular anomalies in the thorax which disturb the functions of the esophagus or trachea can now be treated with an excellent chance of relieving the obstructive symptoms.

Is There an Association Between Hemangioma and Syndromes With Dysmorphic Features?

PEDIATRICS ◽  
1991 ◽  
Vol 88 (6) ◽  
pp. 1257-1267
Author(s):  
A. Jay Burns ◽  
Lawrence C. Kaplan ◽  
John B. Mulliken
Keyword(s):  
Aortic Arch ◽  
Vascular Malformations ◽  
Vascular Anomalies ◽  
Vascular Lesions ◽  
Dysmorphic Features ◽  
Vascular Birthmarks ◽  
Neonatal Tumor ◽  
Nevus Flammeus ◽  
Genitourinary Defects

Most vascular birthmarks can be categorized, based on clinical and cellular criteria, as either (1) a hemangioma, or (2) a malformation, or (3) a macular stain. Macular stains are commonly seen in newborns, and they consist of faint vascular stains of the glabella, eyelids, and nuchal region called "nevus flammeus," "stork bite," "salmon patch," etc. Unfortunately, the term "hemangioma" is frequently applied to all three types of cutaneous vascular lesions. Usually, these disparate vascular anomalies are listed in association with various malformative syndromes and are generically labeled "hemangioma." This study attempts to define accurately the specific vascular anomalies seen in children born with syndromes with dysmorphic features. This review of five standard textbooks of genetics showed that the majority of vascular anomalies reported in syndromic newborns are not hemangiomas. Rather, they are macular stains, and the vast majority of these fade with time. Congenital telangiectasias and other vascular malformations (capillary, lymphatic, venous, arterial, and combinations thereof) also occur in association with dysmorphic syndromes. contrast, hemangioma, the most common neonatal tumor, is seen only incidentally with rare dysmorphic conditions. Specifically, hemangioma was found to occur only in association with midline (sternal, abdominal) clefting, right-sided aortic arch coarctation, and with a constellation of sacral and genitourinary defects.

DOZ047.40: Bronchopulmonary and vascular anomalies are frequent in children with esophageal atresia

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
S Lejeune ◽  
A L Mee ◽  
L Petyt ◽  
C Mordacq ◽  
R Sfeir ◽  
...  
Keyword(s):  
Ct Scan ◽  
Esophageal Atresia ◽  
Respiratory Symptoms ◽  
Vascular Malformations ◽  
Vascular Anomaly ◽  
Vascular Anomalies ◽  
Ct Scans ◽  
Congenital Cystic Adenomatoid Malformation ◽  
Pediatric Radiologist ◽  
Contrast Enhanced Ct

Abstract Introduction Esophageal atresia (EA) is frequently associated with other malformations although few data are available. Objective Describe tracheobronchial, pulmonary and/or vascular malformations in patients with EA using chest CT scans. Methods Monocentric retrospective study in children with EA, born between 1996 and 2013, who had a CT scan during their follow-up, reviewed by a pediatric radiologist. Results Among 234 children with EA, 48 patients underwent a CT scan available for interpretation, among which 69% were performed to explore persistent respiratory symptoms. Thirty-nine children (81%) were type III EA, 13 (27%) had a VACTERL association. Six patients (13%) had a pulmonary malformation: 4 lobar agenesis, 1 right pulmonary aplasia, and 1 congenital cystic adenomatoid malformation. All these patients presented with at least one associated malformation. Combined with the results of laryngotracheal endoscopy (n = 30), 43 patients (90%) had a tracheobronchial anomaly: tracheomalacia for 40 (83%), tracheal stenosis for 12 (25%), right tracheal bronchus for 2 (4%), communicating bronchopulmonary foregut malformation for 1 (2%). Combined with the results of echocardiography (n = 47), 7 patients (15%) had an isolated vascular anomaly, 8 (17%) had an isolated congenital heart disease and 7 (15%) had both. CT scans permitted the diagnosis of 6 pulmonary malformations (13%), 15 tracheobronchial anomalies (31%), and 2 vascular anomalies (4%). Only one patient (2%) in our study presented with an isolated EA. Conclusion Our study confirms the association of tracheobronchial, pulmonary, and vascular anomalies in patients with EA. Contrast-enhanced CT scan is complementary to echocardiography and laryngotracheal endoscopy in the exploration of persistent respiratory symptoms.

scholarly journals Peripheral Vascular Anomalies – Essentials in Periinterventional Imaging

2019 ◽  
Vol 192 (02) ◽  
pp. 150-162 ◽  
Author(s):  
Maliha Sadick ◽  
Daniel Overhoff ◽  
Bettina Baessler ◽  
Naema von Spangenberg ◽  
Lena Krebs ◽  
...  
Keyword(s):  
Therapeutic Approach ◽  
Vascular Malformations ◽  
Vascular Anomaly ◽  
Flow Dynamics ◽  
Vascular Anomalies ◽  
Vascular Tumors ◽  
Slow Flow ◽  
Peripheral Vascular ◽  
Fast Flow ◽  
Selection Of

Background Peripheral vascular anomalies represent a rare disease with an underlying congenital mesenchymal and angiogenetic disorder. Vascular anomalies are subdivided into vascular tumors and vascular malformations. Both entities include characteristic features and flow dynamics. Symptoms can occur in infancy and adulthood. Vascular anomalies may be accompanied by characteristic clinical findings which facilitate disease classification. The role of periinterventional imaging is to confirm the clinically suspected diagnosis, taking into account the extent and location of the vascular anomaly for the purpose of treatment planning. Method In accordance with the International Society for the Study of Vascular Anomalies (ISSVA), vascular anomalies are mainly categorized as slow-flow and fast-flow lesions. Based on the diagnosis and flow dynamics of the vascular anomaly, the recommended periinterventional imaging is described, ranging from ultrasonography and plain radiography to dedicated ultrafast CT and MRI protocols, percutaneous phlebography and transcatheter angiography. Each vascular anomaly requires dedicated imaging. Differentiation between slow-flow and fast-flow vascular anomalies facilitates selection of the appropriate imaging modality or a combination of diagnostic tools. Results Slow-flow congenital vascular anomalies mainly include venous and lymphatic or combined malformations. Ultrasound and MRI and especially MR-venography are essential for periinterventional imaging. Arteriovenous malformations are fast-flow vascular anomalies. They should be imaged with dedicated MR protocols, especially when extensive. CT with 4D perfusion imaging as well as time-resolved 3D MR-A allow multiplanar perfusion-based assessment of the multiple arterial inflow and venous drainage vessels of arterio-venous malformations. These imaging tools should be subject to intervention planning, as they can reduce procedure time significantly. Fast-flow vascular tumors like hemangiomas should be worked up with ultrasound, including color-coded duplex sonography, MRI and transcatheter angiography in case of a therapeutic approach. In combined malformation syndromes, radiological imaging has to be adapted according to the dominant underlying vessels and their flow dynamics. Conclusion Guide to evaluation of flow dynamics in peripheral vascular anomalies, involving vascular malformations and vascular tumors with the intention to facilitate selection of periinterventional imaging modalities and diagnostic and therapeutic approach to vascular anomalies. Key Points:  Citation Format

scholarly journals Is secondary tracheomalacia associated with persistent lower respiratory tract inflammation and subclinical infection?

2020 ◽  
Author(s):  
Antonino Capizzi ◽  
Michela Silvestri ◽  
Giovanni Rossi ◽  
Oliviero Sacco
Keyword(s):  
Respiratory Tract ◽  
Haemophilus Influenzae ◽  
Ct Scan ◽  
Aortic Arch ◽  
Lower Respiratory Tract ◽  
Bacterial Load ◽  
Stable Condition ◽  
Innominate Artery ◽  
Vascular Anomalies ◽  
Subclinical Infection

Background. In secondary tracheomalacia due to mediastinal vascular anomalies one of the most prevalent symptom is recurrent lower respiratory tract (LRT) infections, related to defective airway clearance. Whether this condition could result in persistent LRT inflammation and subclinical infection is not known. Patients and methods. Children with tracheomalacia due to mediastinal vascular anomalies, recurrent (>3/y) LRT infections were evaluated while in stable condition. Computed tomography (CT) scan and bronchoscopy with bronchoalveolar lavage (BAL) were performed. Results. 31 children were included in the study: 21 with aberrant innominate artery (AIA), 4 with right aortic arch (RAA) and 1 with double aortic arch (DAA) and 5 with AIA associated with RAA. Cytological evaluation of BAL fluid showed increased neutrophil percentages and normal lymphocyte and eosinophil proportions. Microorganism growth was detected in 35.5% of BAL samples, with a bacterial load >105 colony-forming-units (CFU)/mL only in 10,2% of them. Most isolates were positive for Haemophilus influenzae, followed by Streptococcus pneumoniae, Group A β-hemolytic streptococci and Moraxella catarrhalis. Chest CT scan demonstrated the presence of bronchiectasis in 13% of the children, of which only one had a positive BAL culture for Haemophilus influenzae. Conclusions. Only in a small subgroup of children, persistent neutrophilic alveolitis was associated with a significant bacterial load and the presence of bronchiectasis. Because most pathogens detected in BAL samples cultures can produce biofilms, caution should be used in inappropriate antibiotic prescription in these patients that, chiefly in those with bronchiectasis, in which chest physiotherapy can be of great benefit.

Combined and complex vascular malformations

VASA ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 92-105 ◽  
Author(s):  
Robert K. Clemens ◽  
Thomas Pfammatter ◽  
Thomas O. Meier ◽  
Ahmad I. Alomari ◽  
Beatrice R. Amann-Vesti
Keyword(s):  
Clinical Assessment ◽  
Vascular Malformations ◽  
Correct Diagnosis ◽  
Vascular Anomaly ◽  
Vascular Anomalies ◽  
Imaging Features ◽  
Patient History

The correct diagnosis of vascular malformations is obtainable by clinical assessment and patient history in the majority of cases. Nonetheless, confusion in nomenclature, existence of multiple classifications and rarity of these lesions leads to misdiagnosis and related wrong treatment. This is especially the case in combined or complex vascular malformations or vascular malformations that are part of syndromes as these have overlapping clinical and imaging features. New entities in the field of vascular anomalies have been described recently like fibro-adipose vascular anomaly or central conducting lymphatic anomalies.

Lasertechniques treatment of vascular malformations

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 167-175
Author(s):  
M. Poetke ◽  
P. Urban ◽  
H.-P. Berlien
Keyword(s):  
Endothelial Cells ◽  
Spontaneous Regression ◽  
Vascular System ◽  
Vascular Malformations ◽  
Clinical Importance ◽  
Vascular Structure ◽  
Laser Application ◽  
Vascular Morphogenesis ◽  
Structural Abnormalities

SummaryVascular malformations are structural abnormalities, errors of vascular morphogenesis, which can be localized in all parts of the vascular system. All vascular malformations by definition, are present at birth and grow proportionately with the child; their volume can change. In contrast to the haemangiomas, which only proliferate from the endothelial cells the division in stages is of clinical importance. Vascular malformations are divided from the part of vascular system, which is affected.In principle the techniques of laser application in congenital vascular tumours like haemangiomas and in vascular malformations are similar, but the aim is different. In tumours the aim is to induce regression, in vascular malformations the aim is to destroy the pathologic vascular structure because there is no spontaneous regression. This means that the parameters for treatment of vascular malformations must be more aggressive than for vascular tumours.

scholarly journals A rare pediatric case of cluster headaches after cardiac catheterization in a patient with an isolated innominate artery

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110236
Author(s):  
Kimberley Yu ◽  
Madeline Chadehumbe
Keyword(s):  
Aortic Arch ◽  
Cardiac Catheterization ◽  
Innominate Artery ◽  
Dopamine Antagonists ◽  
Autonomic Tone ◽  
Pediatric Case ◽  
Cluster Headaches ◽  
Insight Into ◽  
Secondary Causes ◽  
Isolated Innominate Artery

While cluster headaches are classified and considered a primary headache disorder, secondary causes of cluster headaches have been reported and may provide insight into cluster headaches’ potential pathophysiology. The mechanisms underlying this headache phenotype are poorly understood, and several theories have been proposed that range from the activation within the posterior hypothalamus to autonomic tone dysfunction. We provide a review of reported cases in the literature describing secondary causes after cardiac procedures. We will present a novel pediatric case report of a 16-year-old boy with an isolated innominate artery who presented with acute new-onset headaches 8 h following cardiac catheterization of the aortic arch with arteriography and left pulmonary artery stent placement. The headaches were characterized by attacks of excruciating pain behind the left eye and jaw associated with ipsilateral photophobia, conjunctival injection, rhinorrhea, with severe agitation and restlessness. These met the International Classification of Headache Disorders-3 criteria for episodic cluster headaches. The headaches failed to respond to non-steroidal anti-inflammatory medications, dopamine antagonists, and steroids. He showed an immediate response to treatment with oxygen. This unique case of cluster headaches following cardiac catheterization in a pediatric patient with an isolated innominate artery may provide new insight into cluster headaches’ pathogenesis. We hypothesize that the cardiac catheterization induced cardiac autonomic changes that contributed to the development of his cluster headaches. The role of aortic arch anomalies and procedures in potential disruption of the autonomic tone and the causation of cluster headaches is an area requiring further study.

scholarly journals Penetrating Injuries to the Innominate Artery in Association with Abnormal Aortic Arch Anatomy

2002 ◽  
Vol 23 (5) ◽  
pp. 462-464
Author(s):  
J.D. Woolgar ◽  
J.V. Robbs ◽  
P. Rajaruthnum ◽  
G.S. Mohamed
Keyword(s):  
Aortic Arch ◽  
Innominate Artery ◽  
Penetrating Injuries

One-Stage Repair of Cardiac and Arch Anomalies without Circulatory Arrest

2003 ◽  
Vol 11 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Kona Samba Murthy ◽  
Robert Coelho ◽  
Christopher Roy ◽  
Snehal Kulkarni ◽  
Benjamin Ninan ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Aortic Arch ◽  
Septal Defect ◽  
Circulatory Arrest ◽  
Coarctation Of The Aorta ◽  
Innominate Artery ◽  
Double Outlet Right Ventricle ◽  
Interrupted Aortic Arch ◽  
Ischemic Time ◽  
Arch Obstruction

Between 1999 and 2002, 23 patients underwent single-stage complete repair of cardiac anomalies and aortic arch obstruction, without circulatory arrest. Median age was 1.2 years. Intracardiac defects included ventricular septal defect in 9, double-outlet right ventricle in 6, d-transposition of the great arteries and ventricular septal defect in 2, subaortic obstruction in 3, and atrial septal defect in 3. Fourteen patients had coarctation of the aorta, 6 had coarctation with hypoplastic aortic arch, and 3 had interrupted aortic arch. Simple techniques were employed such as cannulation of the ascending aorta near the innominate artery and maintaining cerebral and myocardial perfusion. After correction of arch obstruction, intracardiac repair was undertaken. The mean cardiopulmonary bypass time was 169 min, aortic crossclamp time was 51 min, and arch repair took 16 min. There was no operative mortality or neurological deficit. In follow-up of 1–43 months, no patient had residual coarctation. This simplified technique avoids additional procedures, reduces ischemic time, and prevents problems related to circulatory arrest.

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