title: [Emergency Thoracic Endovascular Aortic Repair of Ruptured Kommerell's Diverticulum with an Acute Aortic Dissection].
abstract: This case report describes emergency thoracic endovascular aortic repair (TEVAR) of a ruptured Kommerell's diverticulum associated with a type B acute aortic dissection in a patient with a right aortic arch. A 64-year-old male was admitted with symptoms of sudden paraplegia and shock. The computed tomography imaging showed right aortic arch anomaly, with mirror image branching of the major arteries. The aorta was dissected from the origin of the right subclavian artery to the terminal aorta, with a thrombosed false lumen. Rupture was found in a 6.3 cm aneurysm located in the distal arch, which was diagnosed as Kommerell's diverticulum. We performed emergency TEVAR, and the aneurysm was successfully excluded using deployment of a Gore Tag stent-graft. At 3 months' follow-up, the patient was doing well and showed shrinkage of the aneurysm was confirmed. TEVAR is considered to be a suitable procedure for an emergency aortic catastrophe even in patients with aortic anomaly.
authors.affiliation: Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Seguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtake
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yoshimura
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Shintani
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishida
authors.forename: Ryuta
authors.initials: R
authors.lastname: Kiuchi
authors.forename: Shojiro
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Tomita
authors.forename: Junichiro
authors.initials: J
authors.lastname: Sanada
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D004240:Diverticulum / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed