Management options for Kommerell's diverticulum.

An aberrant right subclavian artery (ARSA) arising from a left-sided aortic arch (LAA) is an uncommon aortic arch anomaly. Aneurysms of ARSA arising from different degrees of Kommerell's diverticulum may modify surgical approach. We describe a safe technique for the surgical management of ARSA aneurysm in a 67-year-old gentleman. We performed exclusion of an ARSA aneurysm using left heart bypass, with concomitant R axillary to RSCA bypass. This obviated the need for any major procedure such as an aortic arch replacement.