Document Detail


Kommerell's diverticulum and aneurysmal right-sided aortic arch: a case report and review of the literature.
MedLine Citation:
PMID:  11107094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Right-sided aortic arch is a rare variant of the thoracic vascular anatomy that may be accompanied by an aberrant origin of the left subclavian artery. We report a true aneurysm of the distal arch and descending thoracic aorta in a patient with right-sided arch and review previous descriptions of aneurysms of anomalous right-sided aortas. In our patient, the left subclavian artery originated at the junction between the distal arch and the descending thoracic aorta located in the right chest and was aneurysmal (Kommerell's diverticulum); the thoracic aorta was also aneurysmal. Extra-anatomic left subclavian-to-carotid transposition was performed before the intrathoracic procedure. Subsequently, a right thoracotomy provided adequate exposure for repairing the aortic aneurysm and oversewing the aneurysmal origin of the subclavian artery. Because the distal aortic arch was involved, deep hypothermia and circulatory arrest were used. Only five previous instances of true aneurysms of a right-sided aortic arch have been reported; four of these patients underwent operative repair (via bilateral thoracotomy, median sternotomy, or right thoracotomy). We believe that a right thoracotomy provides good exposure and avoids the morbidity associated with bilateral thoracotomy. The reconstruction of the subclavian artery has not previously been reported in this setting. Performing subclavian reconstruction as an extrathoracic procedure before the intrathoracic repair would be expected to reduce the subsequent risk of distal ischemia or subclavian steal without increasing the overall morbidity associated with the procedure.
Authors:
C S Cinà; G O Arena; G Bruin; C M Clase
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  32     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-01-08     Completed Date:  2001-01-08     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1208-14     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Angiography
Aorta, Thoracic / abnormalities*
Aortic Aneurysm, Thoracic / radiography,  surgery*
Follow-Up Studies
Humans
Male
Middle Aged
Radiography, Thoracic
Subclavian Artery / abnormalities*
Thoracotomy
Time Factors
Tomography, X-Ray Computed
Comments/Corrections
Comment In:
J Vasc Surg. 2004 Jun;39(6):1360; author reply 1360-1   [PMID:  15206414 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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