Optimal Surgical Strategy for Kommerell's Diverticulum Associated with a Right-Sided Aortic Arch: A Report of Four Cases.

INTRODUCTION

Kommerell's diverticulum is often associated with a right-sided aortic arch. It presents as a saccular aneurysm. Although various surgical strategies have been reported, optimal treatment has not been established.

CASE PRESENTATION: Four patients with right-sided aortic arch underwent different surgeries for Kommerell's diverticulum. The pattern of aortic arch was a mirror-image of the normal left aortic arch in Cases 1 and 2. In Cases 3 and 4, it was right-sided aortic arch with an aberrant left subclavian artery as its last branch. Cases 1 and 3 presented with compression symptoms caused by Kommerell's diverticulum. They underwent open surgery or thoracic endovascular aortic repair through the different approaches. Their postoperative courses were favorable.

CONCLUSIONS

The surgical strategy for Kommerell's diverticulum with a right-sided aortic arch should be selected based on the anatomical characteristics of the cervical vessels, compression symptoms, and surgical risks.