Japanese Journal of Cardiovascular Surgery Vol46,No4

Surgical Treatment of Kommerell Diverticulum and the Aberrant Subclavian Artery:Four Case Reports

Hideaki Kanda* Yukinori Moriyama* Yutaka Imoto**
Yoshihiro Fukumoto* Takayuki Ueno* Kazuya Terazono*

(Department of Cardiovascular Surgery, Kagoshima Medical Center*, Kagoshima, Japan, and Cardiovascular and Gastrointestinal Surgery, Kagoshima University Graduate School of Medical and Dental Sciences**, Kagoshima, Japan)

We report 4 cases of aortic graft replacement for Kommerell diverticulum(KD)and the aberrant subclavian artery(ASA). In two patients who had a right-sided aortic arch, KD and the left ASA, we performed descending aorta replacement and in-situ reconstruction of the left ASA via a right lateral thoracotomy. Third patient had a left-sided aortic arch, KD and the right ASA, in whom we performed descending aorta graft replacement via a left lateral thoracotomy with ostial closure of the right ASA. Fourth patient had a left-sided aortic arch, KD and the right ASA, and complicated by acute type A aortic dissection. We performed a total arch repair with frozen elephant trunk procedure via a median sternotomy. All 4 patients survived operations and discharged from the hospital with symptom relief. The choice of approach, a thoracotomy or a median sternotomy, should be based on patient-specific anatomy and extent of graft replacement.


Jpn. J. Cardiovasc. Surg. 46:173-176(2017)

Keywords:aberrant subclavian artery;thoracic aneurysm;Kommerell diverticulum

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