The incidence of congenital vascular ring malformation is low, the anatomical type is variable, it can occur alone or in combination with other congenital heart diseases, the clinical manifestations are variable, there are no specific symptoms or heart murmurs, and it is very easy to be misdiagnosed or missed clinically. Some doctors do not know about vascular ring malformation and think that the treatment effect is not good because the child has heavy symptoms, which may delay the treatment of the child. Therefore, according to the actual situation of Nanjing Children’s Hospital, I would like to talk about the following issues of concern to parents and pediatricians: which cases should be considered for the existence of congenital vascular ring, common types of vascular ring, how to diagnose and treat, as well as the effect and cost of treatment. A. What conditions should be considered for the possible existence of a vascular ring Simple vascular ring malformation mainly shows compression of the trachea, and the clinical manifestations are different according to the symptoms of compression, so it is very easy to misdiagnose or miss the diagnosis. When children have the following symptoms, they should be alert to the presence of vascular rings and pay attention to the investigation. 1. Repeated respiratory infections, which are poorly treated. 2. The child has recurrent shortness of breath, shortness of breath, and wheezing. 3.Pediatric chest radiography with pulmonary atelectasis or CT examination with tracheal stenosis. 4.The child has unexplained symptoms of feeding obstruction 2.Common vascular ring malformation 1.Complete vascular ring: including double aortic arch, right aortic arch combined with left duct/ligament or left aortic arch combined with right duct/ligament. Complete vascular rings form a complete ring structurally to encircle the trachea and esophagus, resulting in compression and compression symptoms in children. 2. Partial vascular ring: Partial vascular ring does not form a complete ring anatomically, but the same symptoms as complete vascular ring appear due to abnormal vascular anatomy compressing trachea and esophagus, including pulmonary artery sling and vagus vascular malformation. If a child has the above symptoms, he should make an appointment for 64-row CT or other high-speed CT imaging in time to clarify or exclude the vascular ring malformation, which is of great value in diagnosing the vascular ring. At the same time, an appointment should be made for cardiac ultrasound to clarify whether there is any malformation in the heart. Treatment of vascular ring malformation 1.Complete vascular ring, such as double aortic arch, etc., once clearly diagnosed, should be treated by surgery as soon as possible. 2.Pulmonary artery sling also forms obvious compression on the trachea, the diagnosis is clear, and surgery should be performed as soon as possible. For those without obvious symptoms, such as vagal left subclavian artery or vagal right subclavian artery, they can be clinically followed up. V. Surgical effect The surgical effect is a concern of parents. For vascular ring malformations detected in time, the growth and development and quality of life can be similar to those of normal people after surgery. However, there are some children with tracheal softening due to late detection or compression, and there is no particularly good solution for these children. There is no uniform standard for vascular ring malformation, which has a large variation. For those who need surgery in the neonatal period, it is necessary to prepare about 80,000-100,000, for those who need surgery around 6 months of age, about 60,000-80,000, and for those who are 1 year old and above, it is necessary to prepare about 50,000, and the cost also depends on the development of the child itself and whether other malformations in the heart are combined. In conclusion, for children with recurrent pulmonary infections, shortness of breath and dyspnea, pediatric medicine should pay attention to the differential diagnosis of congenital vascular ring malformation and perform 64-row CT examination in a timely manner to clarify or exclude vascular ring malformation. According to the anatomical variation of the vascular ring malformation and whether it is combined with intracardiac malformation, the corresponding surgical treatment can significantly improve the clinical symptoms of the child and achieve very good treatment results.