title: Surgical repair of Kommerell's diverticulum and an aberrant subclavian artery.
abstract: OBJECTIVE
  The coexistence of Kommerell's diverticulum and an aberrant subclavian artery (ASCA) is a rare congenital variation of the vascular structure. We report our experience of treating aneurysms associated with these anomalies.
  
  
  METHODS
  Between June 2007 and November 2011, five consecutive patients underwent repair of an aneurysm associated with Kommerell's diverticulum and an ASCA at Shiga University Hospital. Four of the five patients had a right-sided aortic arch associated with the ASCA. One patient underwent emergency surgery for a ruptured thoracic aneurysm. The operations performed were descending aorta replacement through right thoracotomy in one patient and total arch replacement through a median thoracotomy, under deep hypothermic circulatory arrest and selective cerebral perfusion, in four patients. No staged operation was required.
  
  
  RESULTS
  One patient died of mediastinitis, subsequent to a ruptured Kommerell's diverticulum, 45 days postoperatively. There were no other deaths in the early or late (6-58 months) postoperative period. One patient required re-exploration for bleeding, but none of the patients suffered neurologic complications.
  
  
  CONCLUSIONS
  Aortic disease with an ASCA and Kommerell's diverticulum can be repaired safely under elective conditions.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowacho, Otsu, Shiga, 520-2192, Japan, sohosoba@belle.shiga-med.ac.jp.
authors.forename: Soh
authors.initials: S
authors.lastname: Hosoba
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Tohru
authors.initials: T
authors.lastname: Asai
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Nota
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuroyanagi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Takashima
authors.forename: Masato
authors.initials: M
authors.lastname: Hayakawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002315:Cardiopulmonary Bypass; D018376:Cardiovascular Abnormalities / Q000150:complications / Q000601:surgery*; D050792:Circulatory Arrest, Deep Hypothermia Induced; D003680:Deglutition Disorders / Q000150:complications / Q000601:surgery*; D004240:Diverticulum / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013348:Subclavian Artery / Q000002:abnormalities* / Q000601:surgery; D013908:Thoracotomy