Hybrid repair of Kommerell's diverticulum with aberrant subclavian artery.

Kommerell's diverticulum (KD) is a rare aortic arch anomaly associated with aberrant subclavian arteries and risk of rupture. We present an 80-year-old woman with a right-sided aortic arch and aberrant left subclavian artery arising from a 5.0-cm KD. A staged hybrid repair was performed: right carotid-subclavian bypass, thoracic endovascular aortic repair, and embolization of the aberrant subclavian artery. Postoperative imaging confirmed complete exclusion of the diverticulum and a patent bypass graft. This case illustrates the safety and effectiveness of hybrid repair for KD in complex arch anatomy, offering a less invasive alternative to open surgery.