Bovis ISSN 2398-2993

Vascular ring anomalies

Synonym(s): Persistent right aortic arch, double aortic arches, anomalous subclavian arteries

Contributor(s): Louise Cox-O’Shea, Vetstream Ltd , Gayle Hallowell

University of Nottingham logo

Introduction

  • Very rarely identified in cattle.
  • Usually no cardiovascular signs.
  • Most common (95%) - persistent right aortic arch (PRAA).
  • Less common - double aortic arches, anomalous subclavian arteries.
  • Cause:
    • developmental abnormality of vessels.
    • Esophageal dilation cranial to base of heart.
  • Signs: regurgitation, intermittent bloat, aspiration pneumonia, stunted growth.
  • Diagnosis: signs, radiography, endoscopy.
  • Treatment: limited as usually not financially viable or practical.
  • Prognosis: depends on degree of megaesophagus, but generally poor.

Pathogenesis

Etiology

  • Congenital:
    • Persistent right aortic arch (stricture caused by ligamentum or Ductus arteriosus Ductus arteriosus, pulmonary artery and dextraposed aorta)
    • Double aortic arches
    • Anomalous subclavian arteries.

Pathophysiology

  • Aberrant embryological development of great vessels at the heart base → esophagus encircled at the heart base by a right aortic arch, a ligamentum arteriosum (or patent ductus arteriosus) and the pulmonary trunk → accumulating food boluses proximal to vascular ring → esophageal dilation and eventual loss of function (megaesophagus) → typical signs of megaesophagus.
  • Fibrosis may occur affecting adventitia around esophagus at site of vascular ring → esophageal stenosis.
  • Aspiration pneumonia Aspiration pneumonia is a common complication.

Timecourse

  • Varies depending on the degree of obstruction and severity of megaesophagus.
  •  Aspiration pneumonia adds further complications and increases mortality.

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMed Resource.
  • Jalilzadeh-Amin G & Hashemiasl S (2015) Megaoesophagus in the upper cervical oesophagus  in a steer: a case report. Veterinarni Medicina 60 (1), pp 48–51.
  • Miki W, Takehana K, Kusaba N, Suzuki T et al (2009) A case of a right aortic arch in a Japanese black calf with symptoms of persistent ruminal tympany and dysphagia. Journal of the Japan Veterinary Medical Association 62 (6), pp 460-463.
  • Du Plessis C J, Keller N & Joubert K E (2006) Symmetrical double aortic arch in a beagle puppy. JSAP 47 (1), 31-34.
  • House A K, Summerfield N J, German A J, Noble P J M, Ibarrola P & Brockman D J (2005) Unusual vascular ring anomaly associated with a persistent right aortic arch in two dogs. JSAP 46, 585-590 PubMed.
  • Vianna M L, Krahwinkel D J Jr (2004) Double aortic arch in a dog. JAVMA 225 (8), pp 1222-1224, 1196-1197 PubMed.
  • Buchanan J W (2003)Tracheal signs and associated vascular anomalies in dogs with persistent right aortic arch.JVIM18(4), 510-514PubMed.
  • Findji L & Degueurce C (1999)Symmetrical double aortic arch in a dog. Vet Rec 145(10), 456-466.
  • Van Grundy T (1989) Vascular ring anomalies. Comp Cont Ed Pract Vet 11, 36-48.
  • Fingeroth J M & Fossum T W (1987) Late onset regurgitation associated with persistent right aortic arch in two dogs. JAVMA 191, 981.
  • Helphrey M L (1979) Vascular ring anomalies in the dog. Vet Clin North Am Small Anim Prac (2), 207-219.

Other sources of information

  • Fingeroth J M (1993) Surgical diseases of the esophagus. Vascular ring anomalies and surgical techniques for oesophageal disease. Correction of vascular ring anomalies.In:Textbook of Small Animal Surgery. 2nd edition. Ed: Slatter D. Philadelphia: W B Saunders. pp 538-544, 554-557.
  • Noden D M & DeLahunta A (1985) Cardiovascular system I. Blood and arteries. In:The Embryology of Domestic Animals. Developmental Mechanisms and Malformations. Baltimore: Williams & Wilkins. pp 211-230.


ADDED