Successful Conservative Treatment of a Kommerell Aneurysm Associated With Right-Sided Aortic Arch

Lococo, Filippo; Tusini, Nicola; Brandi, Loris; Leuzzi, Giovanni; Galeone, Carla; Paci, Massimiliano; Rapicetta, Cristian

doi:10.1177/1538574416655891

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Thoracic aortic endovascular repair and aortic arch debranching either endovascular or surgically are treatment options in patients with comorbidities. 2,8 In the present case, the patient was scheduled for close follow-up since surgery or endovascular intervention could not be performed due to comorbidities.…”

Section: Discussionmentioning

confidence: 95%

Bone Deformities as a Complication of Giant Thoracic Aortic Aneurysm

Aslan

Kartal

Ayaz

et al. 2017

Vasc Endovascular Surg

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The contained rupture of thoracic aortic aneurysm and related bone deformities is a rare condition. The diagnosis is critical due to potential and fatal complications. Radiologic evaluation is required to show the location, extension, and complications. Herein we present the X-ray radiography, ultrasonography, computed tomography, and magnetic resonance images of a giant dissected and contained rupture of the thoracic aortic aneurysm. The aneurysm destructed the adjacent vertebrae and rib, resulting in compression of dural sac and spinal cord, and obliteration of the neural foramina. Our case demonstrates a gigantic expansion of an aneurysm (14 cm) with chronic skeletal complications.

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Section: Discussionmentioning

confidence: 95%

Bone Deformities as a Complication of Giant Thoracic Aortic Aneurysm

Aslan

Kartal

Ayaz

et al. 2017

Vasc Endovascular Surg

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“…They are extremely rare, as they can be found only in 3-8% of the KD [5][6][7]. Some authors have stated that a KA should be defined when the size of a KD is greater than 30 mm, since the risk of rupture (rKA) increases significantly, yet there is still no consensus [8,9]. Histological studies highlight that KA requires a separate categorisation that distinguishes them from KD, as it has been demonstrated that medial cystic necrosis is present in the vessel wall of the KA [10].…”

Section: Introductionmentioning

confidence: 99%

“…Due to the implications of this condition, including death, emergent surgical repair is usually granted. Some elective surgical approaches have been proposed; however, evidence regarding the optimal emergent management for KA and rKA is mainly based on isolated case reports or a few KD cohorts, as shown in Table 1 [2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Emergent hybrid surgical approaches for non-dissecting ruptured Kommerell's aneurysm: a case report series

Velandia-Sánchez

Gómez-Galán

Gallo-Bernal

et al. 2023

J Cardiothorac Surg

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Background Kommerell’s aneurysm is a saccular or fusiform dilatation found in 3–8% of Kommerell’s diverticulum cases. A non-dissecting rupture rate of 6% has been reported. If ruptured, emergent surgical correction is usually granted. However, evidence regarding the optimal surgical approach in this acute setting is scarce. In this case report series, we aim to describe our experience managing type-1 non-dissecting ruptured Kommerell's aneurysm with hybrid emergent surgical approaches. Cases presentation From January 2005 to December 2020, three cases of type-1 non-dissecting ruptured Kommerell's aneurysm requiring emergent surgical repair were identified. The mean age was 66.67 ± 7.76 years, and 3/3 were male. The most common symptoms were atypical chest pain, dyspnoea, and headache (2/3). The mean aneurysm’s diameter was 63.67 ± 5.69 mm. Frozen Elephant Trunk was the preferred surgical approach (2/3). The Non-Frozen Elephant Trunk patient underwent a hybrid procedure consisting of a supra-aortic debranching and a zone-2 stent-graft deployment. We found a mean clamp time of 140 ± 60.75 min, cardiac arrest time of 51.33 ± 3.06 min, and a hospital stay of 13.67 ± 5.51 days. The most common complications were surgical-site infection and shock (2/3). Only one patient died (1/3). Conclusion Evidence of management for non-dissecting ruptured Kommerell's aneurysms is scarce. Additional, robust, and more extensive studies are required. The selection of the appropriate surgical approach is challenging, and each patient should be individualized. Frozen Elephant Trunk was feasible for patients requiring emergent surgical repair in our centre. However, other hybrid or open procedures can be performed.

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“…Due to the implications of this condition, including mortality, emergent surgical repair is usually granted. Some surgical approaches have been proposed; however, evidence regarding the optimal management for KA and rKA is mainly based on isolated case reports or a few KD cohorts, as shown in Table 1 (2,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Emergent Hybrid Surgical Approaches for Non-Dissecting Ruptured Kommerell's Aneurysm: A Case Series

Velandia-Sánchez

Gómez-Galán

Gallo-Bernal

et al. 2022

Preprint

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Background Kommerell's diverticulum is a rare developmental abnormality of the aorta, associated in 20–60% of the cases with an aberrant subclavian artery. A Kommerell’s aneurysm is a saccular or fusiform dilatation that can be found in 3–8% of Kommerell’s diverticulum cases. A non-dissecting rupture rate of 6% has been reported. Because the patient's life is at risk, emergent surgical correction is usually granted. Different surgical interventions have been proposed, including open, endovascular, or hybrid approaches. However, evidence regarding the optimal surgical approach in the acute setting is scarce. In this case series, we aim to describe our surgical experience in the management of type-1 non-dissecting ruptured Kommerell's aneurysm. Cases presentation: From January 2005 to December 2020, three cases of type-1 non-dissecting ruptured Kommerell's aneurysm requiring emergent surgical repair were identified. The mean age was 66.67 ± 7.76 years, and 3/3 were male. The most common symptoms were atypical chest pain, dyspnea, and headache (2/3). The most frequent comorbidity was hypertension (2/3). The mean aneurysm’s diameter was 63.67 ± 5.69 mm. Frozen Elephant Trunk was the preferred surgical approach (2/3). The Non-Frozen Elephant Trunk patient underwent a hybrid procedure consisting of a carotid-subclavian bypass and a zone-2 stent graft deployment. We found a mean clamp time of 140 ± 60.75 min, cardiac arrest time of 51.33 ± 3.06 min, and a hospital stay of 13.67 ± 5.51 days. The most common complications were surgical-site infection and shock (2/3). Only one patient died (1/3). Conclusion Evidence involving the accurate diagnosis, prevention, and management of type-1 non-dissecting ruptured Kommerell's aneurysms is scarce. Additional, robust, and more extensive studies are required. The selection of the appropriate surgical approach is challenging. In our experience, Frozen Elephant Trunk was feasible for patients requiring emergent surgical repair. However, other hybrid procedures can be performed.

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Successful Conservative Treatment of a Kommerell Aneurysm Associated With Right-Sided Aortic Arch

Cited by 4 publications

References 5 publications

Bone Deformities as a Complication of Giant Thoracic Aortic Aneurysm

Bone Deformities as a Complication of Giant Thoracic Aortic Aneurysm

Emergent hybrid surgical approaches for non-dissecting ruptured Kommerell's aneurysm: a case report series

Emergent Hybrid Surgical Approaches for Non-Dissecting Ruptured Kommerell's Aneurysm: A Case Series

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