Hybrid Repair in a Patient with Kommerell Diverticulum and Right Aortic Arch

Abstract

We experienced a hybrid repair for Kommerell diverticulum and right aortic arch. A 62-year-old man with dyspnea and dysphagia was referred to our hospital. He underwent atrium septum defect closure when he was 15 years old and was found to have ventricular septal defect and severe aortic regurgitation at the referring hospital. Preoperative computed tomography incidentally showed right aortic arch and Kommerell diverticulum with aberrant left subclavian artery. First, we performed ventricular septal defect closure and aortic valve replacement. Three months later, we performed one-stage hybrid repair of Kommerell diverticulum that included left common carotid-subclavian artery bypass, left subclavian artery plug occlusion and descending aortic replacement via a right thoracotomy. This hybrid strategy did not require in-situ reconstruction of the aberrant subclavian artery and minimized the risk of bleeding, injuries of esophagus and recurrent laryngeal nerve. The postoperative course was uneventful. This hybrid repair is a safe and effective procedure for Kommerell diverticulum with aberrant subclavian artery.