Translocation of aberrant left subclavian artery and resection of Kommerell's diverticulum by total arch replacement via median sternotomy.

Abstract

Background: Various methods for reconstructing the left subclavian artery and approaches to treat aortic aneurysms associated with Kommerell's diverticulum and an aberrant left subclavian artery arising from a right-sided aortic arch have been reported.

Case presentation: The case involved a 69-year-old woman, in whom a right-sided aortic arch with Kommerell's diverticulum and a left subclavian artery originating from the diverticulum were incidentally observed. Severe stenosis was noted on the origin of the left subclavian artery, and the diameter of Kommerell's diverticulum had expanded to 64 mm, resulting in dysphagia. Therefore, a total arch replacement was performed via median sternotomy. For reconstruction, the left subclavian artery was anastomosed to the left common carotid artery. Kommerell's diverticulum was successfully resected through a median sternotomy. The postoperative course was uneventful, and the patient was discharged home without complications.

Conclusion: Translocation of the aberrant left subclavian artery is a simple procedure and is effective during total arch replacement via a median sternotomy.