title: Two-Stage Hybrid Repair in a Patient with Acute Type A Aortic Dissection Associated with Right Aortic Arch with Aberrant Left Subclavian Artery Originating from a Kommerell Diverticulum.
abstract: Right aortic arch with aberrant left subclavian artery and Kommerell diverticulum are rare anomalies. A 42-year-old man was referred with sudden-onset chest pain. Enhanced computed tomography (CT) showed a right aortic arch with early thrombosed acute type A aortic dissection and an aberrant left subclavian artery arising from a Kommerell diverticulum. Medical therapy was instituted; however, follow-up CT revealed an ulcer-like projection. The patient was managed with a two-stage hybrid procedure comprising total arch replacement and endovascular repair and experienced no postoperative complications. Two-stage hybrid repair is a safe and effective surgical option for rare complex aortic anomalies.
authors.affiliation: Department of Cardiovascular Surgery, JA Nagano Koseiren Shinonoi General Hospital, Nagano, Nagano, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Doi
authors.affiliation: Department of Cardiovascular Surgery, JA Nagano Koseiren Shinonoi General Hospital, Nagano, Nagano, Japan.
authors.forename: Kimimasa
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Department of Cardiovascular Surgery, JA Nagano Koseiren Shinonoi General Hospital, Nagano, Nagano, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Gyoten
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Toyama, Toyama, Toyama, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Nagura
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Toyama, Toyama, Toyama, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Yamashita
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Toyama, Toyama, Toyama, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Fukahara
authors.affiliation: Department of Thoracic and Vascular Surgery, Toyama City Hospital, Toyama, Toyama, Japan.
authors.forename: Keiju
authors.initials: K
authors.lastname: Kotoh
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Toyama, Toyama, Toyama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
keywords: Kommerell diverticulum; right aortic arch with aberrant left subclavian artery; two-stage hybrid repair