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Double Aortic Arch With Kommerell Diverticulum.

Carl L Backer1, Sandeep N Bharadwaj2, Osama M Eltayeb1

  • 1Division of Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

The Annals of Thoracic Surgery
|March 9, 2019
PubMed
Summary
This summary is machine-generated.

Patients with a double aortic arch and Kommerell diverticulum (KD) can experience significant relief after surgical intervention. This study highlights the successful outcomes of excising the KD alongside standard vascular ring surgery.

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Thoracic Surgery

Background:

  • Kommerell diverticulum (KD) is typically associated with right aortic arch variants.
  • A rare presentation involves KD occurring with a double aortic arch, a condition less commonly documented.

Purpose of the Study:

  • To characterize the demographics and surgical outcomes of patients with a double aortic arch and KD.
  • To evaluate the efficacy of surgical intervention for this specific vascular anomaly.

Main Methods:

  • Retrospective review of 10 patients who underwent surgery for double aortic arch with KD between 2002 and 2017.
  • Analysis of preoperative imaging, surgical procedures, and postoperative outcomes, including symptom resolution and length of stay.

Main Results:

  • All 10 patients had a right-dominant double aortic arch and KD, with significant mean distal tracheal compression (63%).
  • Surgical procedures included division of the left aortic arch, ligamentum, and KD resection.
  • No major complications or readmissions occurred; 50% of patients reported complete symptom resolution, and the other 50% reported substantial relief.

Conclusions:

  • Double aortic arch with KD is a distinct clinical entity that can be effectively managed surgically.
  • Excision of the Kommerell diverticulum, in addition to standard vascular ring division, is recommended for optimal patient outcomes.