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A vascular ring occurs when the aorta — the body’s largest blood vessel — or its branches develop abnormally, so that they encircle and obstruct the trachea and esophagus. Although not all vascular rings cause symptoms, those that create swallowing and breathing problems typically need surgery. Treatment of vascular rings requires a variety of advanced diagnostic and therapeutic techniques by a team of physicians experienced in cardiovascular, esophageal, and airway surgery.

The Vascular Ring and Airway Compression Program at Boston Children’s brings together surgeons from the hospital’s Benderson Family Heart Center and Esophageal and Airway Treatment (EAT) Center — in addition to cardiologists, pulmonologists, gastroenterologists, otorhinolaryngologists, and orthopedic surgeons — to collaborate on the care of children with vascular rings or airway compression syndromes. The breadth of our team’s specialty experience allows us to take a more comprehensive approach to the diagnosis and management of vascular rings. This unique collaborative effort helps ensure that the condition is treated thoroughly — preventing the need for future operations. In addition to surgically repairing vascular rings, our skilled surgeons revise incomplete and failed vascular ring repairs performed elsewhere.

Boy wearing glasses and sitting on swing looks up at camera

After surgery, playing and eating are a breeze for Louis

Surgery corrected Louis' double aortic arch, a type of vascular ring that had made breathing and eating difficult.

Our approach to vascular ring and airway compression treatment

Boston Children’s has been at the forefront of treatment for vascular ring and airway compression for nearly a century. In 1945, Dr. Robert E. Gross pioneered a surgical procedure to treat double aortic arch, a common type of vascular ring, by dividing one of the two aortic arches. Today, our world-renowned team of specialists continues to develop innovative treatments and update conventional ones to create the most appropriate individualized care plans for children with vascular rings.

We’re one of the few pediatric hospitals to perform advanced operations such as:

  • Descending aortic translocation: This operation reconstructs the aortic arch in patients with tracheobronchial compression caused by the aorta being slung over the airway.
  • Aortic elongation: This procedure lengthens either the ascending or descending aorta to relieve compression caused by an aorta that is too short.
  • Aortic uncrossing: To relieve swallowing difficulties, this operation reroutes the aorta in patients who have a circumflex aorta or an aorta that passes behind the esophagus.
  • Sternal advancement: We are the only hospital in the world that offers sternal reconstruction to relieve crowding between a patient’s sternum and spine.

In addition to physicians and surgeons, our team includes experts from a range of disciplines, including:

Together, we provide coordinated care to your family, through diagnosis, treatment, and long-term follow-up. We are committed to achieving the best possible health outcome for your child.

Young boy walks down wide sidewalk holding a stuffed animal in his right hand.

Finding answers for a complex vascular ring

The first sign that Levi would no longer have problems swallowing was when, only three days after a complex surgery, he wolfed down four chicken nuggets and an apple.