Kommerell's diverticulum (KD) is a rare congenital vascular abnormality due to the formation of an abnormal aortic arch, most commonly associated with dilatation at the proximal part of the aberrant subclavian artery. This article describes an option of surgical treatment in a patient with KD. The proposed new technique of aortic arch surgical reconstruction with a stent-graft placement in the descending aorta reduces CPB time, aortic clamp and circulatory arrest time.

Суханов Сергей Германович-д-р мед. наук, профессор, главный врач 1 Марченко Андрей Викторович-д-р мед. наук, заместитель главного врача 1

No abstract

This article presents an observation of a clinical case in a patient with the postoperative sternomediastinitis. In cardio-thoracic surgery this complication ranges from 1 to 10 % [2, 3, 14, 16, 19] depending on who the work is done by and the ratio of deaths can reach up to 40 % [13]. Due to untimely diagnosis of the pyoinflammatory process in the tracheostomy orifice, the patient developed progressive instability of the sternum followed by sternomediastinitis. A two-staged tactics of treatment of the postoperative sternomediastinitis using the technique of negative pressure followed by two-flap omentoplasty according to K. Yoshida in this case is the technique of choice for surgical treatment, which allows to restore the integrity of the chest wall frame in the shortest possible time and ensure tightness for the mediastinum. This technique is the most effective in the treatment of destructive forms of purulent complications of the sternum after a median sternotomy. The relevance and expediency of the use of omentoplasty is also justified from a financial and medico-social position, since the procedure reduces mortality among patients of this category, as well as the risk of severe disability at the able-bodied age.