Surgical treatment for Kommerell's diverticulum

Area of Science:

• Cardiovascular Surgery
• Congenital Heart Disease
• Thoracic Surgery

Background:

• Kommerell's diverticulum is a rare congenital aortic arch anomaly.
• Established surgical treatment strategies remain elusive for this condition.

Purpose of the Study:

• To evaluate the safety and efficacy of surgical interventions for Kommerell's diverticulum.
• To present midterm outcomes of patients treated for this rare aortic arch abnormality.

Main Methods:

• Retrospective analysis of 6 patients undergoing surgery for Kommerell's diverticulum (1994-2004).
• Procedures included aortic arch replacement and aberrant subclavian artery reconstruction or ligation.
• Surgical approaches involved median sternotomy with right thoracotomy or isolated thoracotomy.

Main Results:

• No operative mortality or rehospitalization; one case of mediastinitis resolved with drainage and omentopexy.
• Symptomatic relief in dysphagia patients; satisfactory postoperative angiograms.
• All patients resumed normal activities at midterm follow-up (mean 55.6 months) without complications.

Conclusions:

• Kommerell's diverticulum can be safely repaired using graft replacement and in situ reconstruction of the aberrant subclavian artery.
• Thoracotomy provides a viable surgical approach for managing this congenital aortic anomaly.