[Total Arch Replacement using the Frozen Elephant Trunk for Kommerell Diverticulum with Right Aortic Arch:Report of a Case].

ABSTRACT

A 42-year-old woman with dysphagia was referred to our hospital. Computed tomography (CT) revealed Kommerell diverticulum( KD) associated with right aortic arch( RAA) and aberrant left subclavian artery (ALSCA). We performed total arch replacement (TAR) using a frozen elephant trunk (FET) technique. We ligated ALSCA at the distal portion of the KD after perfusing from a 8 mm tubular graft from left axillar artery. We inserted a FET from the ascending aorta to avoid locating the nonstented portion at the steep-angled site of RAA. Postoperatively dysphagia disappeared and CT scan showed complete exclusion of KD without leakage of the stent graft and successful reconstruction of the arch. The TAR and FET technique is an effective procedure for KD with RAA and ALSCA.