We report a rare case of a rupture in Kommerell's diverticulum in a 73-year-old woman with Edwards IIIB aberrant left subclavian artery (A-LSA) and right aortic arch. This case was further complicated by an inferior vena cava defect. We performed an emergency operation through a right posterolateral approach. The descending aorta was replaced and the Kommerell's diverticulum was excised, followed by A-LSA reconstruction, performed under deep hypothermia with selective cerebral perfusion. We believe the prognosis was excellent.
Surgical embolectomy for high-risk AMPE patients has an excellent operative mortality and long-term outcome. Preoperative PCPS may lead to an immediate stable haemodynamic state and improve surgical embolectomy results, especially in high-risk patients (e.g. those with preoperative CPA). Surgical embolectomy for AMPE is an established operation and considered as the first-line therapy.
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