A Case Report after Two Years of Total Debranching and Endovascular Repair for Kommerell Diverticulum

Masato Hayakawa＊	Isao Nishizima＊	Takaaki Nagano＊＊
Kento Shinzato＊	Ryo Ikemura＊	Kazufumi Miyagi＊
Kiyoshi Iha＊	Shigenobu Senaha＊＊＊	Mitsuyoshi Shimoji＊＊＊
Mitsuru Akasaki＊＊＊

（Department of Cardiovascular Surgery, Chubu Tokushukai Hospital＊, Okinawa, Japan, Department of Thorac and Cardiovascular Surgery, Graduate School of Medicine, University of The Ryukyus＊＊, Okinawa, Japan, and Division of Cardiovascular Surgery, Nanbu Tokushukai Hospital＊＊＊, Okinawa, Japan）

A 78-year-old woman with abnormal shadows on computed tomography（CT）was given a diagnosis of right-sided aortic arch and Kommerell diverticulum（KD), accompanied by aberrant left subclavian artery. Although no symptoms were observed, the maximum diameter of the aneurysm was 63mm, and surgical intervention was chosen because of the possibility of rupture. At first, a 4-branched blood vessel prosthesis with a side branch was anastomosed to the ascending aorta. Next, after reconstructing the cervical branches, a Conformable GORE●R TAG●R（W.L. Gore and Associates, 34mm×200mm）was inserted from the side branch and expanded in the range of Zones 0 to Th 7. Finally, ALSA coil embolization was performed. She was discharged on postoperative day 36, and at her 2-year follow-up, she was doing well, with shrinkage of Kommerell diverticulum.

 

Jpn. J. Cardiovasc. Surg. 48:202-205（2019）

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