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Updated: Nov 9, 2025

Three-Dimensional Printing of a Complex Aortic Anomaly
Published on: November 1, 2018
Ultrastructural Features of the Aortic Wall in a Patient with Kommerell Diverticulum
Naritomo Nishioka1, Yutaka Iba1, Hiroki Bochimoto2
1Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan.
Abstract:
We report on the ultrastructural features of the aortic wall in a patient with Kommerell diverticulum. A 70-year-old woman with a right aortic arch, aberrant left subclavian artery, and Kommerell diverticulum underwent a successful total arch replacement plus the frozen elephant trunk procedure with anatomical left subclavian artery reconstruction. Small pieces of the ascending aorta, distal arch, right common carotid artery, and left subclavian artery were investigated ultrastructurally. In the ascending aortic wall, multiple cystic cavities were observed in the subintimal region of the media by scanning electron microscopy. Changes in organelles, including mild dilation of rough-surfaced endoplasmic reticulum and mitochondrial swelling and degrading, were also observed in all specimens by transmission electron microscopy. These ultrastructural features may indicate the fragility or stress of the aortic wall and are useful when considering the early surgical intervention of a patient with Kommerell diverticulum.
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