What is the most common vascular ring?

• A. Double aortic arch
• B. Right aortic arch with aberrant left subclavian
• C. Left aortic arch
• D. Coarctation of the aorta

Answer: (A)

Vascular rings are congenital anomalies where parts of the aortic arch system encircle the trachea and esophagus, potentially causing compression in infancy. The most common scenario in which a complete ring forms is when both the right and left aortic arches persist, creating a full circle around the airway and esophagus. This configuration is more likely to produce symptoms like stridor or feeding difficulties, making it the typical vascular ring seen. A left aortic arch by itself is normal anatomy and does not encircle. A right aortic arch with an aberrant left subclavian can form a ring, but it is less common. Coarctation of the aorta narrows the vessel and does not create a complete ring around the trachea and esophagus.