Double aortic arch – rings, slings


Vascular rings arise when the originally pairwise formed aortic arches fail to disappear or do not do so completely. Several aortic arches may remain. The trachea and the esophagus run between the ring that is formed and as the patient grows they may be compromised. This causes wheezing, shortness of breath and swallowing disorders. Typical examples are the double aortic arch and the right aortic arch with left ductus.
Vascular slings do not surround the esophagus and trachea entirely but can compromise and compress the trachea leading to symptoms. Typical examples: Slings of the left pulmonary artery (LPA), where the LPA first runs on the far right, then crossing to the left between the esophagus and the trachea; truncus brachiocephalicus, in which the trunk originates a long way to the left from the aortic arch and causes ventral compression of the trachea.