Concomitant Kommerell diverticulectomy, carotid-subclavian bypass, and modified ravitch pectus excavatum repair via...

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Congenital Malformations

Background:

• Congenital heart disease (CHD) can coexist with pectus excavatum, presenting complex surgical challenges.
• The optimal surgical strategy, whether concomitant or staged repair, remains a subject of debate.
• Associated vascular anomalies, such as Kommerell diverticulum, can complicate surgical planning.

Purpose of the Study:

• To report a case of concomitant repair of complex CHD and pectus excavatum.
• To evaluate the feasibility and safety of a single-stage surgical approach.
• To review existing literature on operative strategies for combined CHD and pectus excavatum repair.

Main Methods:

• A 17-year-old male with left aortic arch, aberrant right subclavian artery, Kommerell diverticulum, and pectus excavatum underwent surgical intervention.
• The procedure involved Kommerell diverticulectomy, carotid-subclavian bypass, and modified Ravitch pectus excavatum repair.
• The repair was performed as a single operation via sternotomy.

Main Results:

• The patient presented with dysphagia, nausea, and cosmetic concerns related to pectus excavatum.
• The concomitant surgical repair was successfully completed without any complications.
• The patient experienced relief from swallowing difficulties and cosmetic improvement.

Conclusions:

• Concomitant surgical repair of congenital heart disease and pectus excavatum is feasible and safe when performed in a single operation via sternotomy.
• This approach can effectively address both cardiovascular and thoracic wall abnormalities simultaneously.
• Further investigation into the comparative outcomes of concomitant versus staged repairs is warranted.