[Dissecting aortic aneurysm involving an aberrant right subclavian artery]

A 51-year-old man was admitted with severe interscapular and chest pain. Chest X-ray showed marked widening of the mediastinum. Aortography demonstrated DeBakey IIIb type dissecting aortic aneurysm and an aberrant right subclavian artery arising from the diverticulum of Kommerell. The intimal tear was repaired with direct suture closure with the aid of femoro-femoral bypass. Although the dissecting lumen was not obliterated completely, the patient has been well for seven years on antihypertensive treatment. This is a rare combination of congenital and acquired disease of the aorta. As far as we know, this is the first report in Japanese literature.