Abstract
Kommerell diverticulum (KD) is an aneurysm of the orifice of an aberrant subclavian artery (SCA) from the descending aorta or aortic arch. We have performed two-staged surgical strategy for the treatment of KD with right aortic arch. The first step was the bypass grafting between the left common carotid artery and the aberrant left SCA with occlusion of the distal side of KD with the plug. The second step was the descending aorta replacement through the right thoracotomy. Four patients underwent these operations. No hospital deaths or major complications were observed. All four patients were discharged and have been alive for 1–6 years without any health problems. Two of four patients had symptoms of dysphagia preoperatively, and it resolved postoperatively in both patients. No hoarseness occurred after surgery, and 1–6 years of CT observation showed no recanalization of the vascular plug.
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References
Kommerell B. Verlagerung des Oesophagus durch eine abnorm verlaufende Arteria subclavia dextra (Arteria Lusoria). Fortschr Geb Roentgenstrahlen. 1936;54:590–5.
Reece TB, Wallen TJ, Jagasia DH, Bavaria JE, Szeto WY. Open thoracic repair for dysphagia in patients with Kommerell’s diverticulum and right-sided aortic arch with aberrant left subclavian artery. J Card Surg. 2010;1:62–4.
Kouchoukos NT, Masetti P. Aberrant subclavian artery and Kommerell aneurysm: surgical treatment with a standard approach. J Thorac Cardiovasc Surg. 2007;133:888–92.
Tsukui H, Aomi S, Yamazaki K. Surgical strategy for Kommerell’s diverticulum: Total arch replacement. J Thorac Cardiovasc Surg. 2014;148(4):1423–7.
Tsukube T, Ataka K, Sakata M, Wakita N, Okita Y. Surgical treatment of an aneurysm in the right aortic arch with aberrant left subclavian artery. Ann Thorac Surg. 2001;71:1710–1.
Edwards JE. Anomalies of the derivatives of the aortic arch system. Med Clin North Am. 1948;32:925–49.
Li Z, Wu R, Liu C, et al. Endovascular repair for Kommerell diverticulum with typeA aortic dissection. Ann Thorac Surg. 2020;110:e217–9.
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Maekawa, A., Takami, Y., Yamana, K. et al. Two-staged surgical treatment for Kommerell diverticulum with a right aortic arch and an aberrant left subclavian artery. Gen Thorac Cardiovasc Surg 70, 83–86 (2022). https://doi.org/10.1007/s11748-021-01715-0
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DOI: https://doi.org/10.1007/s11748-021-01715-0