Vascular anomalies compressing the oesophagus and trachea

Vascular rings formed by anomalies of major arteries can compress the trachea and oesophagus so much as to cause respiratory distress and dysphagia. Twenty-nine patients with this condition are reviewed and discussed in five groups. The symptoms and signs are noted. Radiological examination by barium swallow is the most useful diagnostic aid. Symptoms can only be relieved by operation. The trachea is often deformed at the site of the constricting ring. Only infrequently is there immediate relief from the pre-operative symptoms. Two babies were successfully treated for an aberrant left pulmonary artery. The diagnosis and treatment of major arterial anomalies which cause compression of the oeso-phagus and trachea are now well established. Although an aberrant right subclavian artery was described in 1794 by Bayford (Fig. 1), who gave the detailed post-mortem finding in a woman who had died from starvation secondary to this anomaly, and a double aortic arch was described by von Siebold (1837), it was not until 1945 that Gross successfully divided a double aortic arch in a 4-month-old infant. Following this success the diagnosis and treatment of this and similar anom-alies became firmly established. MATERIAL The surgical experience will be discussed of 29 patients treated consecutively during a 15-yea