Surgical treatment for Kommerell’s diverticulum

Abstract

Kommerell's diverticulum can be repaired safely with graft replacement concomitant with in situ reconstruction of the aberrant subclavian artery through thoracotomy.

Hybrid Procedure for a Kommerell^|^apos;s Diverticulum in a Right-Sided Aortic Arch

“…One concern for the surgical approach to an aneurysmal Kommerell's diverticulum is the anatomical variation of the aortic arch vessels, especially the ALSCA, which is derived from the diverticulum and runs behind the esophagus. 5,7) A Kommerell's diverticulum has been resected successfully via thoracotomy 8,9) ; however, in the present case, a right thoracotomy would have been required to approach the distal site of the diverticulum, while manipulation of the ALSCA would have been needed in the left thoracic cavity since the diverticulum protruded over spines from the right to the left side. The thoracotomy would have been dangerous as the respiratory function of the patient was deteriorated due to chronic obstructive pulmonary disease.…”

Two Cases of Thoracic Aortic Aneurysm with Right Aortic Arch: Comparison of Two Operative Strategies for Hybrid Thoracic Endovascular Repair

“…4) Since cases of the right aortic arch accompanied by Kommerell's diverticulum or aortic aneurysm are rare, consensus on the surgical indications and methods has not been reached. 5) According to Austin, et al, 6) in 19% of patients with Kommerell's diverticulum, the diverticulum ruptures causing death. Moreover, Cina, et al 7) reported that of 32 cases of Kommerell's diverticulum, 53% presented with rupture or dissociation, and surgery was indicated in patients who could withstand surgery and had a diverticulum with a diameter >3 cm.…”

Right-Sided Aortic Arch With Kommerell’s Diverticulum — Sudden Onset in Infant

“…In the right-sided aortic arch symptoms during infancy can be related to compression of mediastinal structures or to congenital heart abnormalities [4]. Adults present symptoms related to dissection or aneurismal dilatation compressing the surrounding structures and producing cough, choking spells, dyspnoea, stridor, wheezing [1].…”

“…The treatment of Kommerell's aneurysms varies from endoaneurysmorraphy for small aneurysms to interposition of graft for large Kommerell's aneurysms or for Kommerell's aneurysms associated with an aneurysm of the descending thoracic aorta [1,4]. For small Kommerell's aneurysms it may be appropriate to observe the lesions and decide for intervention based on the rate of growth over time.…”