[Two-stage Repair of Kommerell Diverticulum with Right Aortic Arch and Aberrant Left Subclavian Artery:Report of a Case].

A 52-year-old woman was referred to our hospital with a chief complaint of difficulty in swallowing and coughing while eating. Enhanced computed tomography (CT) revealed a Kommerell diverticulum with right aortic arch and aberrant left subclavian artery. The diverticulum compressed the esophagus and trachea. We avoided total aortic arch replacement because there were risks of circulatory arrest, selective cerebral perfusion and neurological complication including injury to recurrent laryngeal nerve. Therefore, we scheduled two-stage repair of the diverticulum. First, we performed axillo-axillary artery bypass and left subclavian artery coil embolization. After 7 days, descending aorta replacement including a diverticulum with right anterior lateral 3rd intercostal thoracotomy and lower body partial extracorporeal circulation was performed. The postoperative course was uneventful and she was discharged 20 days after the initial surgery.