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Total endovascular repair for acute type B dissection in the setting of right aortic arch with aberrant left subclavian artery and Kommerell diverticulum 

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Presentation on theme: "Total endovascular repair for acute type B dissection in the setting of right aortic arch with aberrant left subclavian artery and Kommerell diverticulum "— Presentation transcript:

1 Total endovascular repair for acute type B dissection in the setting of right aortic arch with aberrant left subclavian artery and Kommerell diverticulum  Hung-Lung Hsu, MD, Chun-Yang Huang, MD, Jer-Shen Chen, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 150, Issue 2, Pages (August 2015) DOI: /j.jtcvs Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Preintervention computed tomography. The right aortic arch with aberrant left subclavian artery (LSCA) is shown. The first arch branch is the left common carotid artery (LCCA), the second arch branch is the right common carotid artery (RCCA), and the third branch is the right subclavian artery (RSCA) (A). The left subclavian artery took off from the proximal descending aorta, with a Kommerell diverticulum (K) larger than 2 cm in diameter (B and C). The intimal tear was just below the level of the Kommerell diverticulum, and dissection extended upward to the level of the Kommerell diverticulum (C and D). T, True lumen; F, false lumen; L, left. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Postintervention computed tomography at 6-month follow-up. A, Patent Viabahn stent grafts in bilateral subclavian arteries can be seen. B, The Kommerell diverticulum has almost disappeared. C, The 2 Viabahn snorkel grafts went well in parallel in the descending aorta without any compromise. LSCA, Left subclavian artery; LCCA, left common carotid artery; RCCA, right common carotid artery; RSCA, right subclavian artery; L, left. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Three-dimensional reconstructed computed tomography in anteroposterior (left), lateral (center), and left posterior oblique (right) projections gives a clear overview of how the total endovascular repair was achieved. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

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