Debranching and Endovascular Repair for Kommerell’s Diverticulum Involving Right-Sided Aortic Arch with Mirror Image Branching

Satoshi Kamihira

Masanobu Yamauchi

Tadashi Kitano and Kengo Nakayama

（Department of Cardiovascular Surgery, Shimane Prefectural Central Hospital, Izumo, Japan）

A 71-year-old man with an abnormal shadow on chest x-ray was given a diagnosis of Kommerell’s diverticulum involving the right-sided aortic arch with mirror image branching. Furthermore, mild funnel chest had been seen on CT scan more than 10 years earlier. The patient was followed up because there were no symptoms;the Kommerell’s diverticulum expanded to reach 63mm in diameter. To eliminate the risk of rupture, we performed thoracic endovascular aortic repair（TEVAR）with a commercially available device, consisting of bypass grafting of the supra-aortic branches. The patient was discharged from the hospital in good clinical condition, with no signs of endoleak and currently shows no indications of device migration. We thus concluded that debranching TEVAR for Kommerell’s diverticulum with right-sided aortic arch is minimally invasive, safe, and effective. Availability of this device that has a new performance feature is expected to improve treatment results and lead to advances in minimally invasive endovascular repair.

 

Jpn. J. Cardiovasc. Surg. 43:322-325（2014）

Keywords： right aortic arch;Kommerell’s diverticulum;debranching;thoracic endovascular aortic repair（TEVAR）