Hybrid Repair of Distal Aortic Arch Dissection Aneurysm With Dissected Kommerell Diverticulum

2020 ◽  
Vol 54 (4) ◽  
pp. 375-377
Author(s):  
Konstantinos Tigkiropoulos ◽  
Panagiotis Kousidis ◽  
Ioannis Lazaridis ◽  
Nikolaos Saratzis
Keyword(s):  
Aortic Arch ◽  
Treatment Options ◽  
Aberrant Right Subclavian Artery ◽  
Stent Grafting ◽  
Aortic Arch Anomaly ◽  
Adjacent Structures ◽  
Bilateral Carotid ◽  
Risk Of Rupture ◽  
Hybrid Repair ◽  
Kommerell Diverticulum

Aberrant right subclavian artery (ARSA) with associated Kommerell diverticulum (KD) is a rare congenital aortic arch anomaly. Patients with KD have a high risk of rupture, dissection, compression of adjacent structures, as well as distal embolization symptoms. Several treatment options have been proposed (surgical, hybrid, endovascular), however, a consensus regarding optimal surgical management has not been established yet. We present a successful single-stage hybrid repair of distal aortic arch dissection aneurysm with dissecting KD and ARSA with debranching of innominate and left common carotid artery, bilateral carotid-subclavian bypass, and stent grafting.

scholarly journals Hybrid repair of aberrant right subclavian artery with aortic dissection caused by Kommerell diverticulum

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tieyan Li ◽  
Lin Zou ◽  
Yunzhen Feng ◽  
Guoliang Fan ◽  
Yuanfeng Xin
Keyword(s):  
Subclavian Artery ◽  
Treatment Options ◽  
Aortic Disease ◽  
Aberrant Right Subclavian Artery ◽  
Stent Grafting ◽  
Hybrid Operation ◽  
Adjacent Structures ◽  
Risk Of Rupture ◽  
Hybrid Repair ◽  
Kommerell Diverticulum

Abstract Background Aberrant right subclavian artery (ARSA) with associated Kommerell diverticulum (KD) is a rare congenital aortic disease. KD patients have a high risk of rupture, dissection, and compression of adjacent structures. Although several treatment options have been proposed (traditional surgery, hybrid operation, and endovascular intervention), a consensus regarding optimal surgical management has not yet been established. Case presentation A case of successful hybrid repair of distal aortic arch dissection aneurysm by dissecting KD and ARSA with debranching of right and left common carotid arteries, left subclavian artery, and stent grafting was presented. Conclusions The hybrid operation is suitable for elderly patients or those with high risks. Along with intervention, the hybrid operation needs to be developed as a minimally invasive method.

scholarly journals Hybrid Repair of Kommerell Diverticulum in Right Aortic Arch: Anatomic Considerations

2018 ◽  
Vol 105 (4) ◽  
pp. 1279 ◽  
Author(s):  
Salma El Batti ◽  
Iannis Ben Abdallah ◽  
Jean-Marc Alsac ◽  
Pascal Vouhé
Keyword(s):  
Aortic Arch ◽  
Right Aortic Arch ◽  
Hybrid Repair ◽  
Kommerell Diverticulum

scholarly journals The Aberrant Right Subclavian Artery (Arteria Lusoria): The Morphological and Clinical Aspects of One of the Most Important Variations—A Systematic Study of 141 Reports

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Michał Polguj ◽  
Łukasz Chrzanowski ◽  
Jarosław D. Kasprzak ◽  
Ludomir Stefańczyk ◽  
Mirosław Topol ◽  
...  
Keyword(s):  
Weight Loss ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Clinical Aspects ◽  
Arteria Lusoria ◽  
Retrosternal Pain ◽  
Adjacent Structures ◽  
Kommerell’S Diverticulum ◽  
Male Subjects

The most important abnormality of the aortic arch is arguably the presence of an aberrant right subclavian artery (arteria lusoria). If this vessel compresses the adjacent structures, several symptoms may be produced. The aim of the study is to present the morphological and clinical aspects of the aberrant right subclavian artery. Three different databases searched for a review of pertinent literature using strictly predetermined criteria. Of 141 cases, 15 were cadaveric and 126 were clinically documented. The gender distribution of the subjects was 55.3% female and 44.7% male. The mean age of the patients at symptoms onset was49.9±19.4years for all patients but54.0±19.6years and44.9±18.1years for female and male subjects, respectively (P=0.0061). The most common symptoms in this group were dysphagia (71.2%), dyspnea (18.7%), retrosternal pain (17.0%), cough (7.6%), and weight loss (5.9%). The vascular anomalies coexisting with an arteria lusoria were truncus bicaroticus (19.2%), Kommerell’s diverticulum (14.9%), aneurysm of the artery itself (12.8%), and a right sided aortic arch (9.2%). In conclusion, compression of adjacent structures by an aberrant right subclavian artery needs to be differentiated from other conditions presenting dysphagia, dyspnea, retrosternal pain, cough, and weight loss.

scholarly journals Hybrid Repair in a Patient with Kommerell Diverticulum and Right Aortic Arch

2019 ◽  
Vol 48 (5) ◽  
pp. 361-364
Author(s):  
Hiroshi Nakanaga ◽  
Hayato Morimura ◽  
Nobuhiko Hiraiwa ◽  
Minoru Tabata
Keyword(s):  
Aortic Arch ◽  
Right Aortic Arch ◽  
Hybrid Repair ◽  
Kommerell Diverticulum

scholarly journals Right Aortic Arch, Kommerell Diverticulum, and Symptomatic Retro-Esophageal Vascular Ring in an Adult (Case Presentation and Review)

2020 ◽  
Vol 104 (1-2) ◽  
pp. 39-42
Author(s):  
Raymond A. Dieter ◽  
George B. Kuzycz ◽  
Robert W. Kemp ◽  
Juliet H. Fallah ◽  
Deborah M. Budris ◽  
...  
Keyword(s):  
Chest Pain ◽  
Aortic Arch ◽  
Vascular Ring ◽  
Treatment Options ◽  
Symptom Relief ◽  
Right Aortic Arch ◽  
Cervical Approach ◽  
Barium Esophagogram ◽  
Band Crossing ◽  
Kommerell Diverticulum

A 24 year-old Hispanic man presented with progressive retrosternal chest pain, shortness of breath, and dysphagia. Chest X-ray, computed tomography angiography, and magnetic resonance (MRA) studies were compatible with a right aortic arch and a 3.5-cm descending right aortic Kommerell diverticulum. Barium esophagogram and esophagoscopy demonstrated a constricting band crossing the esophagus at the level of the diverticulum. After discussion with other cardiothoracic surgeons, with a combined 300 years of experience, they reported only 1 other possible such case. Kommerell's diverticula are usually repaired in children and rarely are seen in the adult. Kommerell diverticular treatment options include endovascular stenting, cardiopulmonary bypass with resection and grafting, right thoracotomy, and a cervical approach. Because of the patient's findings of a right arch, a Kommerell diverticulum, and a constricting band causing esophageal compression and respiratory distress, it was felt stenting alone would not relieve his symptoms. Therefore, we used a left third posterior intercostal thoracotomy approach to resect the constricting esophageal band connecting the Kommerell diverticulum to the left subclavian artery and to perform the Kommerell diverticulectomy. Releasing the esophageal and tracheal compressing band and resection of the diverticulum provided complete symptom relief with elimination of the dysphagia, dyspnea, wheezing, and chest pain, using a single surgical procedure.

scholarly journals One-Stage Hybrid Repair of a Kommerell Diverticulum with Right Aortic Arch and Aberrant Left Subclavian Artery

2021 ◽  
Vol 50 (5) ◽  
pp. 328-332
Author(s):  
Hiroki Moriuchi ◽  
Masaaki Koide ◽  
Yoshifumi Kunii ◽  
Minori Tateishi ◽  
Satoshi Okugi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Right Aortic Arch ◽  
One Stage ◽  
Aberrant Left Subclavian Artery ◽  
Hybrid Repair ◽  
Kommerell Diverticulum
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