- VernacularTitle:鎖骨下動脈起始異常を伴う Kommerell 憩室の4手術例
- Author:
Hideaki Kanda
;
Yukinori Moriyama
;
Yutaka Imoto
;
Yoshihiro Fukumoto
;
Takayuki Ueno
;
Kazuya Terazono
- Keywords: aberrant subclavian artery; thoracic aneurysm; Kommerell diverticulum
- From:Japanese Journal of Cardiovascular Surgery 2017;46(4):173-176
- CountryJapan
- Language:Japanese
-
Abstract:
We report 4 cases of aortic graft replacement for Kommerell diverticulum (KD) and the aberrant subclavian artery (ASA). In two patients who had a right-sided aortic arch, KD and the left ASA, we performed descending aorta replacement and in-situ reconstruction of the left ASA via a right lateral thoracotomy. Third patient had a left-sided aortic arch, KD and the right ASA, in whom we performed descending aorta graft replacement via a left lateral thoracotomy with ostial closure of the right ASA. Fourth patient had a left-sided aortic arch, KD and the right ASA, and complicated by acute type A aortic dissection. We performed a total arch repair with frozen elephant trunk procedure via a median sternotomy. All 4 patients survived operations and discharged from the hospital with symptom relief. The choice of approach, a thoracotomy or a median sternotomy, should be based on patient-specific anatomy and extent of graft replacement.