Vascular ring anomaly
The most common vascular ring anomaly is a persistent right aortic arch with a left ligamentum arteriosum, however various other vascular anomalies resulting in tracheoesophageal compression have also been reported, such as persistent right aortic arch and left ligamentum arteriosum with a hypoplastic aberrant left subclavian artery. This latter anomaly has a genetic predisposition in the German Pinscher and Great Dane.
Diagnosis of extracardiac intrathoracic vascular anomalies is of clinical importance, but remains challenging. Traditional imaging modalities, such as radiography, echocardiography, and angiography, are inherently limited by the difficulties of a 2-dimensional approach to a 3-dimensional object. Magnetic resonance imaging and multidetector-row computed tomography are 3-dimensional, noninvasive modalities that are emerging modalities in veterinary medicine.
Clinical signs are usually first evident in young pups with regurgitation, often as puppies start to eat solid food at the time of weaning. Affected animals are often thin and smaller than their littermates, and some are dyspneic because of aspiration pneumonia.
Lateral survey and contrast radiographs of these animals commonly show esophageal constriction at the heart base and precardial esophageal dilation. Ventrodorsal radiographs show a leftward curvature of the trachea.
Treatment usually requires surgical intervention. Most vascular ring anomalies are well managed by a left intercostal approach. Post-operative complications are relatively rare.
In some dogs, primary surgical intervention has been delayed for years and patients invariably have to contend with chronic regurgitation due to megaesophagus, persistent aspiration pneumonia and varying degrees of congestive heart failure.
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