Total Arch and Descending Aortic Replacement for a Kommerell Diverticulum and Right-Sided Aortic Arch with Aberrant Left Subclavian Artery

Shigeru Hattori	Keiji Yunoki	Naoya Sakoda
Atsushi Tateishi	Yasufumi Fujita	Kunikazu Hisamochi
Hideo Yoshida

（Department of Cardiovascular Surgery, Hiroshima City Hospital, Hiroshima, Japan）

A 74-year-old woman was referred to our unit with a chief complaint of dysphagia. Enhanced CT showed a Kommerell diverticulum with a maximum diameter of 46mm, associated with a right-sided aortic arch and aberrant left subclavian artery. We performed two-staged operations:left subclavian-common carotid artery bypass followed by total arch, and descending aortic replacement by an antero-lateral thoracotomy with partial sternotomy（ALPS). The postoperative course was uneventful. Total arch and descending aortic replacement for a Kommerell diverticulum by an ALPS approach is rare. ALPS approach for Kommerell diverticulum achieves safe surgery with good exposure.

 

Jpn. J. Cardiovasc. Surg. 44:279-282（2015）

Keywords：Kommerell diverticulum;right-sided aortic arch;total arch and descending aortic replacement;anterolateral thoracotomy with partial sternotomy