Division of aberrant vessel (vascular ring)
CPT4 code
Name of the Procedure:
Division of Aberrant Vessel (Vascular Ring)
Common Name: Vascular Ring Division
Medical Term: Division of Aberrant Vascular Ring
Summary
Vascular ring division is a surgical procedure to correct an abnormal blood vessel formation that compresses the trachea and esophagus. This involves taking away any abnormal connections of the blood vessels to relieve the pressure on these structures, thus improving breathing and swallowing.
Purpose
The procedure addresses vascular rings, which are congenital abnormalities where blood vessels form a ring around the trachea and esophagus. The goal is to alleviate symptoms like difficulty breathing, swallowing problems, recurrent respiratory infections, and other related issues by surgically correcting the blood vessel formation.
Indications
- Stridor (noisy breathing)
- Recurrent respiratory infections
- Difficulty swallowing (dysphagia)
- Failure to thrive in infants
- Symptoms of compression observed through diagnostic imaging studies
Preparation
- Fasting for at least 8 hours before surgery
- Stopping certain medications as advised by the doctor
- Preoperative blood tests and imaging studies like MRI, CT scan, or barium swallow study to visualize the vascular ring
Procedure Description
- Anesthesia: The procedure is performed under general anesthesia to ensure the patient is unconscious and pain-free.
- Incision: A small incision is made in the chest area.
- Dissection: The surgeon carefully identifies and dissects the abnormal vessels creating the ring.
- Division: The aberrant vessel is divided to release the pressure on the trachea and esophagus.
- Closure: The incision is closed with sutures.
Tools used include surgical scissors, forceps, electrocautery devices, and sometimes advanced imaging technology intraoperatively.
Duration
The procedure typically takes 2 to 3 hours.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Pediatric or Cardiothoracic Surgeon
- Anesthesiologist
- Surgical Nurses
- Operating Room Technician
Risks and Complications
- Infection at the surgical site
- Bleeding
- Injury to surrounding organs and structures
- Anesthesia-related risks
- Rarely, complications such as chylothorax (leak of lymphatic fluid) or vocal cord damage
Benefits
- Improved breathing and alleviation of stridor
- Better swallowing and reduced feeding difficulties
- Reduced risk of respiratory infections
- Enhanced overall growth and development in children
Improvements are typically noticed soon after the recovery period.
Recovery
- Hospital stay of 3 to 5 days post-surgery
- Pain management with prescribed medications
- Avoid strenuous activities for several weeks
- Follow-up appointments to monitor recovery
Alternatives
- Observation and management with inhalers or medications in mild cases
- Non-surgical interventions are generally less effective for vascular rings
- Endoscopic dilation as a temporary measure for severe symptoms
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel anything. Post-procedure, some pain and discomfort at the incision site are expected and managed with medication. There may be temporary restrictions on activity levels, and gradual resumption to normal diet and activities is encouraged according to the doctor's advice.