Aortic arch reconstruction using a Kommerell diverticulum for hypoplastic left heart syndrome with a right aortic arch Shunsuke Matsushima, MD, Yoshihiro.

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Presentation transcript:

Aortic arch reconstruction using a Kommerell diverticulum for hypoplastic left heart syndrome with a right aortic arch Shunsuke Matsushima, MD, Yoshihiro Oshima, MD, PhD, Hironori Matsuhisa, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 152, Issue 1, Pages e35-e37 (July 2016) DOI: 10.1016/j.jtcvs.2016.01.057 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 (A) Serial multidetector CT images obtained after bilateral pulomary artery banding revealing a vascular ring composed of a hypoplastic right aortic arch, a left ductus arteriosus (DA), and a Kommerell diverticulum (KD). (B) Images obtained after the Norwood procedure. The new right aortic arch was reconstructed without aortic obstruction and had a sufficient aortopulmonary space. LCA, Left carotid artery; LSA, left subclavian artery; RCA, right carotid artery; RSA, right subclavian artery; T, trachea. The Journal of Thoracic and Cardiovascular Surgery 2016 152, e35-e37DOI: (10.1016/j.jtcvs.2016.01.057) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Schematic diagram of the Norwood procedure. (A) The Kommerell diverticulum (KD) and ductus arteriosus (DA) were mobilized to the right side of the trachea (blue arrow), and the ductal tissue was completely excised (dotted line). (B) The neoaortic root was joined to the Kommerell diverticulum with the glutaraldehyde-treated autologous pericardial (GA-AP) patch, followed by opening the superior wall of the Kommerell diverticulum longitudinally (dashed line). (C) This continuity from the neoaortic root to the descending aorta was anastomosed to the longitudinally opened aortic arch. ePTFE, Expanded polytetrafluoroethylene; LCA, left carotid artery; LSA, left subclavian artery; PA, pulmonary artery; RCA, right carotid artery; RSA, right subclavian artery; RVPAS, right ventricle to pulmonary artery shunt; T, trachea. The Journal of Thoracic and Cardiovascular Surgery 2016 152, e35-e37DOI: (10.1016/j.jtcvs.2016.01.057) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Norwood modification using a Kommerell diverticulum for HLHS with a right aortic arch. The Journal of Thoracic and Cardiovascular Surgery 2016 152, e35-e37DOI: (10.1016/j.jtcvs.2016.01.057) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions