Surgical treatment for kommerells diverticulum sciencedirect. Extrinsic esophagus compression produced by vascular structures is. Kommerells diverticulum, which is a rare condition, is a congenital abnormality of the aortic arch. In this lesion the right subclavian artery arises as the fourth branch of the aorta distal to the origin of the left subclavian artery, then comes to the right arm posterior to the esophagous. Aberrant right subclavian artery arteria lusoria aneurysm with a. Aberrant right subclavian artery arsa with kommerell s diverticulum, is a rare congenital anomaly of the aortic arch found at postmorten examination with a frequency of 0,5%.
However planning the strategy of operation is difficult without a 3d imaging. Saccular kommerell aneurysm, a potential pitfall on mdct. However, vascular causes should be considered in the algorithm when evaluating patients who present with dysphagia, especially when there is compression of the esophagus noted on imaging or examination. Kommerell diverticulum and aberrant right subclavian artery. This saccular aneurysmal dilation at the origin of aberrant subclavian artery consists of an aneurysm of the thoracic aorta as well as an aneurysmal opening of an aberrant subclavian artery 2, 3.
Arena, md, gerard bruin, md, frcpc, and catherine m. Before and during world war i, he studied at the schiller gymnasium in berlin 19101920, where he became a skillful pianist and a prolific composer. Right aortic arch with aberrant left subclavian artery from a kommerells diverticulum is a very rare variant of the incomplete vascular ring. Right aortic arch and kommerells diverticulum repaired.
This happens when there is pressure on your pharynx and it balloons out. A rightsided aortic arch with kommerells diverticulum of. Kommerells diverticulum and aneurysmal rightsided aortic arch. Zenkers diverticulum repair what is zenkers diverticulum. Between 1994 and 2004, 6 patients underwent surgery for kommerells diverticulum at our. Pdf first described in 1936, the diverticulum of kommerell dok is a dilatation of the. We present biographical information about kommerell, as supplied by family members, and comment on the surgical relevance of. Saccular kommerell aneurysm, a potential pitfall on mdct imaging. Aberrant right subclavian artery from an aneurysmal. Twentytwo patients underwent repair of aberrant subclavian arteries and associated kommerell diverticulum. Before and during world war i, he studied at the schiller gymnasium in berlin 19101920, where he. Kommerell aneurysms and diverticula are normally repaired in a twostaged thoracotomy procedure in which the descending aorta and. In this lesion the right subclavian artery arises as the fourth branch of the aorta distal to the origin of the left subclavian artery, then comes to the right arm. Texas heart institute journal volume 9, number 2, 2002.
Right descending aorta with leftsided kommerell diverticulum, typically giving rise to the left sca, which originates in a kink. Cina and colls 7 recommended surgical treatment for aneurysms 3 cm or greater and in ota experience 9 your primary indication was that the diameter of aneurysm was more than 50 mm. Direct origins of the right sca and the right cca from the aortic arch. Kommerell aneurysms and diverticula are normally repaired in a twostaged thoracotomy procedure in which the descending aorta and aberrant subclavian. The treatment options for aberrant right subclavian artery vary depending on the presence of kommerells diverticulum. It is a pouch that forms in your pharynx, an area just above your esophagus or swallowing tube. Conclusions and relevance kommerell diverticulum, a remnant of the left dorsal arch, is a rare cause of dysphagia. The investigators describe an unusual case of tracheal and esophageal compression by atherosclerotic dilatation of the diverticulum of kommerell associated with a congenital aberrant right subclavian artery, illustrating how agingrelated vascular degenerative disease can modify the clinical manifestations of congenital anomalies in an 84yearold man. It is an uncommon condition that occurs in association with a left aortic arch. Burckhard kommerell described an aortic diverticulum for the first time in 1936 in a living patient. Pdf vascular ring related to kommerell diverticula. In the international literature, however, the name of kommerell survives only as an eponym. Dysphagia lusoria caused by kommerell diverticulum revista. Magnetic resonance is the gold standard for diagnosis.
Kommerell diverticulum radiology reference article. We report a case of a 57yearold man with right aortic arch, kommerells diverticulum, and aberrant left subclavian artery. Prenatal diagnosis of vascular ring with right aortic arch dialnet. Any information contained in this pdf file is automatically generated from digital material submitted. Chest computed tomography angiogram showed a rightsided aortic arch with a left aberrant subclavian artery dilated at its origin kommerell diverticulum. The treatment for kommerell diverticulum and aberrant subclavian artery is surgical, with.
Right aortic arch, kommerells diverticulum and aberrant left subclavian artery. Burckhard friedrich kommerells scholarly description of the aortic diverticulum that bears his name was published in 1936. A rightsided aortic arch with kommerells diverticulum of the aberrant left subclavian artery presenting with syncope minghsun yang 1, zenchung weng, yuguo weng2, hsiaohuang chang 1division of cardiovascular surgery, department of surgery, taipei veterans general hospital. Aberrant right subclavian artery and kommerells diverticulum. The presence of a rightsided aortic arch, left ductus arteriosus and aberrant left. Right aortic arch with kommerells diverticulum is a very rare situation. B an illustration shows the obliteration of kommerells diverticulum and the aortosubclavian bypass by artificial conduit arrowhead. Surgical treatment is recommended for symptomatic patients or asymptomatic patients with a large diverticulum.
There is a common wall that separates the esophagus from the diverticulum pouch. The left cca is the first branch given off by the ascending aorta. Aberrant right subclavian artery and calcified aneurysm of. Any information contained in this pdf file is automatically generated from digital. Kommerell diverticula occur in some anomalies of the aortic arch system. Any information contained in this pdf file is automatically generated from. We present a case of incidentally detected rightsided aortic arch with kommerells diverticulum and aberrant left subclavian artery. The strategy of surgical treatment for kommerells diverticulum has not been established.
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