Total arch replacement through a median sternotomy for Kommerell's diverticulum

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Kommerell's diverticulum with right aortic arch and aberrant left subclavian artery is a rare congenital anomaly.
• Optimal surgical management remains debated, particularly regarding the approach to the diverticulum.

Observation:

• The study presents a case of Kommerell's diverticulum with right aortic arch and aberrant left subclavian artery.
• Preoperative computed tomography (CT) was used to guide the surgical strategy.

Findings:

• Total aortic arch replacement was successfully performed using only a median sternotomy.
• This approach was feasible due to the aneurysm's shallow position relative to the tracheal bifurcation.

Implications:

• A median sternotomy alone may be sufficient for total arch replacement in select cases of Kommerell's diverticulum.
• This potentially simplifies the surgical procedure and reduces operative morbidity.