Lodeweges JE, et al. - In this retrospective observational study, researchers used the Dutch Congenital Cor vitia database to study different types of congenital vascular rings based on the anatomy, symptoms, and age at clinical onset as well as their surgical outcomes in a study sample of 69 adult survivors with a history of a vascular ring. Participants presented at a median age of 8.5 years (0-53.0 years). A “left aortic arch with aberrant right subclavian artery” was detected in 30 patients (43.5%), a “double aortic arch” in 21 patients (30.4%), and a “right aortic arch with aberrant left subclavian artery” was present in 16 patients (23.2%). At presentation, respiratory symptoms (82.9%) were mainly evident. Abnormal preoperative spirometry (ie, peak expiratory flows) was more often seen in patients with childhood onset of symptoms vs adult patients. Findings revealed a low incidence of vascular rings. Heterogeneity was evident in their anatomy. Also, these entities had a wide range of common symptoms. All these factors, taken together, often result in misdiagnosis. Surgery could be beneficial in a large subset of patients, even at an adult age, and therefore, clinical awareness is warranted.