The Clinical Report Of 125 Cases With Congenital Vascular Ring And Correlation Analysis Of Missed(misdiagnosis) Diagnosis

Objective : To increase the diagnosis and therapeutic level of congenital vascular ring(CVR)in children.Methods: Retrospectively analyzing the CVR parting,clinical manifestations,first-diagnosis information,accessory examination and treatment of 125 cases with CVR from January 2010 to December 2017 in Children’s Hospital of Chongqing Medical University.According to the diagnosis,patients were divided into missed(misdiagnosis)diagnosis group and diagnosis group,to analyse the risk factors of missed(misdiagnosis)diagnosis.Results: 125 cases diagnosed as CVR were brought into this article,including 73 males and 52 females,the median age is 14.2 months.The diagnosis include 60 cases of PAS,DAA in 42 cases,19 cases of RAA-LDA,4 case of LAA-ARSA.68 cases(54.4%)had respiratory system performance,4 cases(3.2%)had cardiovascular system performance,5 cases(4.0%)had digestive system performance,43 cases(34.4%)had breathing combined cardiovascular system performance,5 patients had no clinical symptoms.74 cases were found with heart malformations,31 cases of them with ASD,9 cases with VSD,11 cases with ASD + VSD and 12 cases with complex cardiac abnomalties.112 cases was found with Tracheostenosis,20 cases with esophageal stenosis,22 cases with laryngeal cartilage dysplasia,6 cases with congenital bronchial pulmonary hypoplasia.The diagnosis accuracy of echocardiographic was 59.3%(67/113)and CTA was 93.4%(114/122),33(100.0%)cases checked with the bronchoscope were all found tracheostenosis;20/26(76.9%)were found with esophageal narrow by accepting line barium esophageal imaging examination.68 cases(54.4%)were first diagnosed in respiratory,23 cases(18.4%)in cardiovascular dept.92(73.6%)cases were diagnosed correctly,33(26.4%)cases were missed(misdiagnosis)diagnosed.Conclusion : the diagnosis rate of CTA is higher than Echocardiography,it’s a better way to diagnose CVR to use Echocardiography combined CTA.Further examination wasn’t be done、 simply ehocardiography and the lack of three-vessel and trachea view might be the reason of missed(misdiagnosis)diagnosis.