Hybrid Approach to a Right Aortic Arch With a Large Kommerell's Diverticulum

A 60-year-old woman with a family history of aortic dissection in her mother was investigated for dysphagia. Her scan showed a right aortic arch with a large Kommerell's diverticulum causing esophageal compression. Her left vertebral artery, which originated abnormally low in the thorax, was embolized preoperatively to limit operative difficulties. Two weeks later, a right thoracotomy allowed the resection of the aneurysm with an associated left carotid-axillary bypass. Partial cardiopulmonary bypass in moderate hypothermia with beating-heart perfusion of the brain was conducted. Five-year follow-up showed a favorable outcome. A multidisciplinary approach is a safe and simple strategy in complex cases.