1.A Case Report after Two Years of Total Debranching and Endovascular Repair for Kommerell Diverticulum
Masato HAYAKAWA ; Isao NISHIZIMA ; Takaaki NAGANO ; Kento SHINZATO ; Ryo IKEMURA ; Kazufumi MIYAGI ; Kiyoshi IHA ; Shigenobu SENAHA ; Mitsuyoshi SHIMOJI ; Mitsuru AKASAKI
Japanese Journal of Cardiovascular Surgery 2019;48(3):202-205
A 78-year-old woman with abnormal shadows on computed tomography (CT) was given a diagnosis of right-sided aortic arch and Kommerell diverticulum (KD), accompanied by aberrant left subclavian artery. Although no symptoms were observed, the maximum diameter of the aneurysm was 63 mm, and surgical intervention was chosen because of the possibility of rupture. At first, a 4-branched blood vessel prosthesis with a side branch was anastomosed to the ascending aorta. Next, after reconstructing the cervical branches, a Conformable GORE® TAG® (W.L. Gore and Associates, 34 mm×200 mm) was inserted from the side branch and expanded in the range of Zones 0 to Th 7. Finally, ALSA coil embolization was performed. She was discharged on postoperative day 36, and at her 2-year follow-up, she was doing well, with shrinkage of Kommerell diverticulum.