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