title: Total arch replacement through a median sternotomy for Kommerell's diverticulum.
abstract: Kommerell's diverticulum with a right aortic arch and aberrant left subclavian artery is a rare anomaly, and the optimal operative strategy has not yet been established. In particular, the approach to the diverticulum is controversial, with the greatest concern being whether or not to add a right thoracotomy to the median sternotomy for distal anastomosis. We successfully performed total arch replacement through a median sternotomy only, by referring to preoperative computed tomography. We think that if the aneurysm is in a shallow position from the tracheal bifurcation, total arch replacement is possible with a midline incision only.
authors.affiliation: 1 Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Goto
authors.affiliation: 2 Nagoya Heart Center, Nagoya, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Koyama
authors.affiliation: 1 Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Soh
authors.initials: S
authors.lastname: Hosoba
authors.affiliation: 1 Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ogawa
authors.affiliation: 1 Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Fukaya
authors.affiliation: 1 Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Okawa
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D018376:Cardiovascular Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D000072226:Computed Tomography Angiography; D004240:Diverticulum / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D056346:Sternotomy; D013348:Subclavian Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
keywords: Aorta; Aortic aneurysm; Blood vessel prosthesis implantation; Diverticulum; Subclavian artery; Vascular surgical procedures; thoracic