title: Surgical strategy for Kommerell's diverticulum with aberrant subclavian artery.
abstract: BACKGROUND
  Kommerell's diverticulum is an extremely rare congenital aortic anomaly. Because of its rarity, the optimal surgical strategy for Kommerell's diverticulum has not been established. In this study, we reviewed our experience of surgical correction of this anomaly.
  
  
  METHODS
  Between 2007 and 2013, we managed 9 surgical cases of Kommerell's diverticulum; 7 had a right aortic arch with an aberrant left subclavian artery, and 2 had a left aortic arch with an aberrant right subclavian artery. None of these patients had any symptom resulting from structural compression between the aneurysm and the aberrant subclavian artery. All patients underwent surgical treatment to prevent aneurysmal rupture. Six patients had replacement of the thoracic descending aorta and in-situ reconstruction of the aberrant subclavian artery through a right thoracotomy, and 3 underwent the same procedures through a left thoracotomy. Three different methods of extracorporeal circulation were applied, according to the anatomical features of each case.
  
  
  RESULTS
  There was one hospital death. This patient developed severe cerebral infarction and died of multiple organ failure on the 65th postoperative day. There were no other major complications nor any need for rehospitalization.
  
  
  CONCLUSIONS
  Kommerell's diverticulum should be treated using an optimal strategy based on each patient's anatomical features and other characteristics.
authors.affiliation: Department of Aortic Surgery, Kawasaki-Saiwai Hospital, Kawasaki, Japan yuji-sekine@kif.biglobe.ne.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sekine
authors.affiliation: Department of Aortic Surgery, Kawasaki-Saiwai Hospital, Kawasaki, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Aortic Surgery, Kawasaki-Saiwai Hospital, Kawasaki, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Fujikawa
authors.affiliation: Department of Aortic Surgery, Kawasaki-Saiwai Hospital, Kawasaki, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Sasaguri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000209:etiology / Q000517:prevention & control; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D018376:Cardiovascular Abnormalities / Q000150:complications / Q000601:surgery*; D004240:Diverticulum / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013348:Subclavian Artery / Q000002:abnormalities / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Aortic aneurysm; aortic diseases; blood vessel prosthesis implantation; diverticulum; subclavian artery; thoracic; vascular surgical procedures