Surgical treatment for Kommerell’s diverticulum

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Presentation transcript:

Surgical treatment for Kommerell’s diverticulum Takeyoshi Ota, MD, PhD, Kenji Okada, MD, PhD, Shuichiro Takanashi, MD, Shin Yamamoto, MD, Yutaka Okita, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 131, Issue 3, Pages 574-578 (March 2006) DOI: 10.1016/j.jtcvs.2005.10.012 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Digital subtraction angiograms of right aortic arch (RAA) and aberrant left subclavian artery (ALSA). A, Early phase. B, Late phase. ALSA arising from the Kommerell’s diverticulum is demonstrated. LC, Left carotid artery; RC, right carotid artery; RS, right subclavian artery; ALS, aberrant left subclavian artery; KM, Kommerell’s diverticulum; Asc.Ao, ascending aorta; Des.Ao, descending aorta. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 574-578DOI: (10.1016/j.jtcvs.2005.10.012) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Contrast-enhanced computed tomography. Kommerell’s diverticulum (arrow 1) was seen. A, Case of RAA and ALSA. The esophagus (arrow 2) was displaced anteriorly. B, Left aortic arch (LAA) and aberrant right subclavian artery (ARSA). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 574-578DOI: (10.1016/j.jtcvs.2005.10.012) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, Surgical view of the RAA with the ALSA through the right thoracotomy. B, A 10-mm graft was anastomosed to the ostium of the aberrant subclavian artery blocking blood backflow using a 5F arterial occlusion catheter. C, The 10-mm graft was anastomosed to the main graft of the descending aorta after proximal anastomosis of the main graft. D, Completed drawing; LC, left carotid artery; RC, right carotid artery; RS, right subclavian artery; ALS, aberrant left subclavian artery; KM, Kommerell’s diverticulum. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 574-578DOI: (10.1016/j.jtcvs.2005.10.012) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Postoperative contrast-enhanced computed tomography of the RAA and ALSA. The 10-mm in situ graft (arrow) for the reconstruction of left subclavian artery was recognized without compression of the esophagus. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 574-578DOI: (10.1016/j.jtcvs.2005.10.012) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions