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Crossed pulmonary arteries as additional cause of dysphagia in association with right aortic arch and Kommerell diverticulum

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Abstract

We describe an uncommon association of crossed pulmonary arteries and a right aortic arch with a Kommerell diverticulum and a left ligamentum arteriosum, resulting in disabling dysphagia in a 33-year-old woman. First, endovascular exclusion of the Kommerell diverticulum was performed using a thoracic stent graft, associated with left subclavian–carotid transposition. Second, open aneurysmorrhaphy and division of the left ligamentum arteriosum allowed a proper release of the oesophageal compression. Dysphagia completely disappeared in the postoperative course. Control computed tomography angiography at 6-month follow-up showed a satisfactory hybrid repair. A complete understanding of the combined effects of these two anatomical variations on oesophageal compression led to a suitable surgical management.

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Authors and Affiliations

  1. Unité de Recherche en Développement, Imagerie et Anatomie, EA4465, Université Paris Descartes, Faculté de Médecine, 45 rue des Saint-Pères, 75006, Paris, France

    Salma El Batti & Iannis Ben Abdallah

  2. Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France

    Salma El Batti, Iannis Ben Abdallah, Pierre Julia, Jean-Marc Alsac & Pascal Vouhé

Authors
  1. Salma El Batti
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  2. Iannis Ben Abdallah
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  3. Pierre Julia
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  4. Jean-Marc Alsac
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  5. Pascal Vouhé
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Contributions

Protocol/project development: SEB and PVData collection or management: SEB, IBA, PJ, and JMAData analysis: SEB, IBA, JMA, PJ, and PVManuscript writing/editing: SEB and IBA.

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Correspondence to Salma El Batti.

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All authors declare that they have no conflict of interest.

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276_2018_2085_MOESM1_ESM.avi

Video: 3D reconstruction of the thoracic aorta with Kommerell diverticulum on a right aortic arch, showing crossed pulmonary arteries and the short mediastinal space in between. (AVI 3601 KB)

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El Batti, S., Ben Abdallah, I., Julia, P. et al. Crossed pulmonary arteries as additional cause of dysphagia in association with right aortic arch and Kommerell diverticulum. Surg Radiol Anat 40, 1165–1168 (2018). https://doi.org/10.1007/s00276-018-2085-2

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  • DOI: https://doi.org/10.1007/s00276-018-2085-2

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