Abstract
BackgroundA strategy for the surgical repair of ruptured Kommerell diverticulum has not yet been established. The aim of this study is to demonstrate that this entity could be associated with a number of other cardiac anomalies and this lesion can be successfully treated by a hybrid approach.Case presentationThe patient, with a combination of ruptured Kommerell diverticulum, dextrorotation, bovine arch, and bicuspid aortic valve, underwent emergency surgery. A single stage hybrid surgical/endovascular repair including subclavian artery revascularization, aortic resection with open proximal anastomosis under circulatory arrest, endovascular stenting, and valve repair was performed. Histological studies indicated the presence of the aortic wall media degeneration. Postoperative course was uneventful and patient is free of symptoms during 2-year follow up.ConclusionsLess invasive hybrid technique is safe and effective treatment option. Accumulated knowledge of Kommerell diverticulum has lead to understanding the best clinical treatment for this complicated aortic anomaly.
Highlights
A strategy for the surgical repair of ruptured Kommerell diverticulum has not yet been established
Kommerell diverticulum (KD) is a congenital anomaly arising from an embryologic remnant of the dorsal fourth aortic arch
Kommerell diverticulum is one of such aortic arch anomalies and is defined as an aortic diverticulum arising at the origin of a subclavian artery from the proximal descending aorta
Summary
Less invasive hybrid technique is safe and effective treatment option. Accumulated knowledge of Kommerell diverticulum has lead to understanding the best clinical treatment for this complicated aortic anomaly.
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