Rupture of Kommerell diverticulum after total arch replacement

Agematsu, Kota; Ueda, Tetsuyuki; Hoshino, S; Nishiya, Y

doi:10.1510/icvts.2010.241802

Cited by 8 publications

(10 citation statements)

References 8 publications

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“…7 The presence of an RAA has been documented to occur in only 0.05% of the population. 8 Aberrant right subclavian arteries can traverse behind the esophagus upward to the contralateral side, going either through the retroesophageal space (80%), between esophagus and trachea (15%) or anterior to the trachea (5%). 9 In our case, we have an aberrant LSA (Left Subclavian Artery) and as per literature, the course can vary; posterior or anterior to esophagus or anterior to both, trachea and esophagus.…”

Section: Discussionmentioning

confidence: 99%

“…16 In a recent study, surgical repair was recommended in symptomatic aneurysm of 5 cm or greater. 7,8 Our patient would likely have benefited from an elective surgical repair since the diameter was close to 5 cm. We recommend assessing every patient with KD putting special attention to the size of the lesion and persistence of symptoms.…”

Section: Surgical Management Of Kdmentioning

confidence: 97%

“…All procedures were two-stage repairs, using a graft to repair the aorta or the subclavian artery, approaching the aorta in the first stage, then approaching the aberrant subclavian artery. 7,8 This approach had zero mortality with only one case developing mediastinitis immediately postoperation. There were no complications in the follow-up period.…”

Section: Surgical Management Of Kdmentioning

confidence: 98%

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Syncope as Initial Presentation of Kommerell Diverticulum

et al. 2012

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Kommerell diverticulum (KD) is an aortic arch diverticulum at the origin of an aberrant subclavian artery. It is a rare anatomical anomaly that can be associated with a double aortic arc, a left aortic arch, and anomalous origin of the right subclavian artery or a right aortic arch with anomalous left subclavian artery. We present a case of KD presenting initially as syncope, as well as a review of the literature of this rare syndrome, including diagnosis, imaging techniques, and current surgical treatments.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Management Of Kdmentioning

confidence: 97%

Section: Surgical Management Of Kdmentioning

confidence: 98%

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Syncope as Initial Presentation of Kommerell Diverticulum

et al. 2012

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“…In cases of right-sided aortic arch, which occurs in 0.5% of the general population, the ALSA occurs in 50% of these cases and arises from a diverticulum at the junction of the aortic arch and the right descending aorta. The ALSA passes obliquely upward behind the esophagus toward the left arm 5 , 6 , 14. The diverticulum occurs in 0.05-0.1% of these cases15 , 16 and is generally well developed because of the fetal ductus arteriosus at the junction of the aberrant artery 10 , 11…”

Section: Discussionmentioning

confidence: 99%

Aortic aneurysm and diverticulum of Kommerell: a dreadful concomitance

Campos

Silva

Martines

et al. 2012

ACR

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First described in 1936, the diverticulum of Kommerell (DOK) is a dilatation of the proximal segment of an aberrant subclavian artery. Appearing more frequently in the left-sided aortic arch, the aberrant right subclavian artery passes behind the esophagus toward the right arm, causing symptoms in the minority of cases. Diagnosis is generally incidental with this pattern. When symptomatic, dysphagia, respiratory symptoms, hoarseness, chest pain, and upper limb ischemia are the most common complaints. Although debatable, the origin of DOK is accepted as being degenerative or congenital. The degenerative condition is normally associated with atherosclerosis and occurs more frequently after the age of 50 years with no gender predominance. Complications may be life threatening and are more commonly related to the diverticulum aneurysm or when associated with aortic diseases such as aneurysms or dissection. The authors present a case of a 67-year-old male with a history of acute chest pain, neurological disturbances, and hypertensive crisis. The diagnostic workup revealed an aortic arch aneurysm with intramural hematoma and a diverticulum aneurysm of Kommerell. Treatment was conservative at first. The patient presented a satisfactory outcome and was referred to an outpatient clinic for follow up and further therapeutic consolidation.

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“…However, the dissected origin of the ARSA is prone to dilate to an aneurismal formation (Kommerell diverticulum) that will cause a rupture or an aorto-esophageal fistula. 6) In this paper, we report a patient with dysphagia after a palliative total arch replacement for a TAAD with an ARSA. The patient successfully underwent a second-stage repair for a Kommerell diverticulum before suffering from critical complications.…”

Section: Introductionmentioning

confidence: 98%

Successful Surgical Exclusion of Rapidly Expanding Kommerell Diverticulum Following a Total Arch Replacement for an Acute Type A Aortic Dissection

Tanaka

Natsume

et al. 2014

Annals of Vascular Diseases

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A 50-year-old man presented with an acute type A aortic dissection with an aberrant right subclavian artery. Emergent total arch replacement with an elephant trunk was performed. Intraoperatively, the origin of the aberrant right subclavian artery could not be resected because it was located too far from the distal arch. After two weeks, the patient became aware of dysphagia. Postoperative computed tomography showed the esophagus was compressed anteriorly by the aneurismal origin of this aberrant vessel (Kommerell diverticulum) with a patent false lumen. Additional replacement of the descending aorta via left thoracotomy was performed immediately to exclude a Kommerell diverticulum.

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Rupture of Kommerell diverticulum after total arch replacement

Cited by 8 publications

References 8 publications

Syncope as Initial Presentation of Kommerell Diverticulum

Syncope as Initial Presentation of Kommerell Diverticulum

Aortic aneurysm and diverticulum of Kommerell: a dreadful concomitance

Successful Surgical Exclusion of Rapidly Expanding Kommerell Diverticulum Following a Total Arch Replacement for an Acute Type A Aortic Dissection

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