Debranching and Endovascular Repair for Kommerell's Diverticulum Involving Right-Sided Aortic Arch with Mirror Image Branching / 日本心臓血管外科学会雑誌

ABSTRACT

A 71-year-old man with an abnormal shadow on chest x-ray was given a diagnosis of Kommerell's diverticulum involving the right-sided aortic arch with mirror image branching. Furthermore, mild funnel chest had been seen on CT scan more than 10 years earlier. The patient was followed up because there were no symptoms ; the Kommerell's diverticulum expanded to reach 63 mm in diameter. To eliminate the risk of rupture, we performed thoracic endovascular aortic repair (TEVAR) with a commercially available device, consisting of bypass grafting of the supra-aortic branches. The patient was discharged from the hospital in good clinical condition, with no signs of endoleak and currently shows no indications of device migration. We thus concluded that debranching TEVAR for Kommerell's diverticulum with right-sided aortic arch is minimally invasive, safe, and effective. Availability of this device that has a new performance feature is expected to improve treatment results and lead to advances in minimally invasive endovascular repair.