A Case of Total Arch Replacement Using Coil Embolization for a Thoracic Aortic Aneurysm Derived from a Kommerell Diverticulum

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  • Sakamoto Ryunosuke
    Department of Cardiovascular Surgery, Saiseikai Shimonoseki General Hospital
  • Takahashi Masaya
    Department of Cardiovascular Surgery, Saiseikai Shimonoseki General Hospital
  • Ikeda Yoshitaka
    Department of Cardiovascular Surgery, Saiseikai Shimonoseki General Hospital
  • Ito Hiroshi
    Department of Cardiovascular Surgery, Saiseikai Shimonoseki General Hospital

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  • Kommerell憩室由来の胸部大動脈瘤に対してコイル塞栓術を併用したTotal Arch Replacement（FET法）の1例

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<p>An 81-year-old man who visited a local physician for evaluation of hoarseness was admitted to our hospital for management of a thoracic aortic aneurysm. Careful examination revealed a thoracic aortic aneurysm, aortic regurgitation, and left ventricular aneurysm. We performed total arch replacement using a frozen elephant trunk prosthesis (combined right axillary artery bypass and coil embolization), aortic valve replacement, papillary muscle approximation, and a septal anterior ventricular exclusion operation. The patient's postoperative course was uneventful, and he was discharged on the 25th postoperative day. A Kommerell diverticulum is located at the origin of an aberrant subclavian artery, and subclavian artery reconstruction via thoracotomy is challenging in such cases. Although increasing numbers of thoracic endovascular aortic repairs have been performed in recent years, the procedure is associated with complications such as endoleak and aortic esophageal fistula, and the surgical risk-benefit ratio should be carefully determined. We report a case of safe non-anatomical subclavian artery reconstruction and coil embolization.</p>

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