Surgical Treatment of Kommerell Diverticulum and the Aberrant Subclavian Artery : Four Case Reports

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  • Kanda Hideaki
    Department of Cardiovascular Surgery, Kagoshima Medical Center
  • Moriyama Yukinori
    Department of Cardiovascular Surgery, Kagoshima Medical Center
  • Imoto Yutaka
    Cardiovascular and Gastrointestinal Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
  • Fukumoto Yoshihiro
    Department of Cardiovascular Surgery, Kagoshima Medical Center
  • Ueno Takayuki
    Department of Cardiovascular Surgery, Kagoshima Medical Center
  • Terazono Kazuya
    Department of Cardiovascular Surgery, Kagoshima Medical Center

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  • 鎖骨下動脈起始異常を伴う Kommerell 憩室の4手術例

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<p>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.</p>

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