title: Surgical treatment for Kommerell's diverticulum.
abstract: OBJECTIVE
  Kommerell's diverticulum, which is a rare condition, is a congenital abnormality of the aortic arch. The strategy of surgical treatment for Kommerell's diverticulum has not been established.
  
  
  METHODS
  Between 1994 and 2004, 6 patients underwent surgery for Kommerell's diverticulum at our institute. Diagnoses included right aortic arch with aberrant left subclavian artery in 4 patients and left aortic arch with aberrant right subclavian artery in 2 patients. Indications for surgery were dilatation of Kommerell's aneurysm (n = 4) and dysphagia (n = 2). One patient underwent total arch replacement through the median sternotomy plus right thoracotomy. Five patients underwent replacement of the descending aorta and reconstruction in situ (n = 4) or ligation (n = 1) of the stenotic aberrant subclavian artery through the right (n = 3) or left (n = 2) thoracotomy.
  
  
  RESULTS
  There were no patient deaths or patients who required rehospitalization. Mediastinitis occurred in 1 patient. This patient required mediastinal drainage and an omentopexy. Two patients who had dysphagia became asymptomatic. Postoperative angiographies in all patients were satisfactory. The patient whose aberrant subclavian artery was ligated had no ischemic symptom of the arm. At the midterm outcomes (mean follow-up length was 55.6 +/- 42.2 months, ranging 10-114 months), all patients resumed normal activities without any complications.
  
  
  CONCLUSIONS
  Kommerell's diverticulum can be repaired safely with graft replacement concomitant with in situ reconstruction of the aberrant subclavian artery through thoracotomy.
authors.affiliation: Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Ota
authors.forename: Kenji
authors.initials: K
authors.lastname: Okada
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
authors.forename: Shin
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery*; D004240:Diverticulum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged