Hybrid repair of a Kommerell diverticulum associated with a right aortic arch and a left descending aorta Hiroyuki Kawajiri, MD, Hideyuki Shimizu, MD,

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Hybrid repair of a Kommerell diverticulum associated with a right aortic arch and a left descending aorta Hiroyuki Kawajiri, MD, Hideyuki Shimizu, MD, PhD, Akihiro Yoshitake, MD, PhD, Ryohei Yozu, MD, PhD Journal of Vascular Surgery Volume 56, Issue 6, Pages 1727-1730 (December 2012) DOI: 10.1016/j.jvs.2012.05.093 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Preoperative computed tomography scan shows the right aortic arch (Ao) connected to the left descending aorta. The trachea overrides the aortic arch. KD, Kommerell diverticulum. B, Two aneurysms are shown as blue-colored areas: a 6.5-cm aneurysmal Kommerell diverticulum (solid arrow), and a 4.0-cm saccular-type aneurysm (dotted arrow; not enhanced because of thromboembolism). Journal of Vascular Surgery 2012 56, 1727-1730DOI: (10.1016/j.jvs.2012.05.093) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Handmade quarto-branched composite graft. Journal of Vascular Surgery 2012 56, 1727-1730DOI: (10.1016/j.jvs.2012.05.093) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Front view of postoperative computed tomography scan. B, Back view shows a long insertion of an elephant trunk graft. C, Postendovascular treatment computed tomography scan shows complete covering of the aortic arch with the endovascular graft. Journal of Vascular Surgery 2012 56, 1727-1730DOI: (10.1016/j.jvs.2012.05.093) Copyright © 2012 Society for Vascular Surgery Terms and Conditions