In these conditions, there is a cessation of respiration with resulting cyanosis. Fortunately, these episodes spontaneously resolve. The most common vascular anomaly is compression from the innominate artery. Diagnosis consists of a rigid bronchoscopy, which will reveal pulsatile anterior tracheal wall compression, and a rigid esophagoscopy, which will not show any compression at all. Because symptoms often resolve after several years, operative intervention is reserved for cases of severe symptoms only.
Surgical correction involves suspending the innominate or the aorta anteriorly to the sternum.
The second most common vascular anomaly is the complete vascular ring, also known as the double aortic arch. This condition provides circumferential compression of both the trachea and esophagus. Symptoms include both dysphagia and dyspnea, and stridor may be present as well. The barium swallow will show circumferential narrowing. Treatment consists of surgically dividing the ring, generally by ligating the smaller of the 2 aortic arches.