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Endovascular Repair for Kommerell Diverticulum With Type A Aortic Dissection
Zilun Li1, Ridong Wu1, Chenshu Liu1
1Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
The Annals of Thoracic Surgery
|February 17, 2020
Summary
Total endovascular repair is a feasible and safe option for select patients with Kommerell diverticulum and chronic type A aortic dissection. This approach successfully excluded the primary entry tear and demonstrated positive aortic remodeling.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Aortic Disease
Background:
- Kommerell diverticulum with chronic type A aortic dissection presents complex challenges for traditional surgical repair.
- Endovascular techniques are increasingly explored for complex aortic pathologies.
Observation:
- A novel total endovascular repair strategy was employed for a patient with Kommerell diverticulum and chronic retrograde type A aortic dissection.
- The procedure utilized a unibody, single-branched stent-graft combined with the chimney technique for bilateral subclavian artery reconstruction.
Findings:
- Completion angiography confirmed complete exclusion of the primary entry tear without endoleak and maintained patency of all stent-grafts.
- Follow-up computed tomographic angiography revealed significant positive remodeling of the false lumen, indicating successful aortic repair.
Implications:
- This case demonstrates the feasibility and safety of total endovascular repair in carefully selected patients with this complex aortic condition.
- The reported technique offers a potentially less invasive alternative for managing Kommerell diverticulum associated with chronic type A aortic dissection.
