An Aberrant Left Subclavian Artery Aneurysm with Right Aortic Arch: Report of a Case

Muraoka, Masashi; Uchiyama, Yoshitaka; Yamaoka, Norio; Yamauchi, Hideto; Hashiyada, Hiroshi; Nakamura, Akihiro; Hashizume, Kazuyoshi; Kondou, Masamichi

doi:10.1007/s005950050490

Cited by 1 publication

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“…More localized aneurysmal dilatation of KD could be addressed by a number of surgical techniques. Options included transposition of the LSCA to the LCCA followed by endoaneurysmorrhaphy [4] or ligation of the proximal and distal ends of the aneurysm followed by bypass between the aorta and LSCA with a synthetic graft [22]. All of the described approaches persevered blood flow through the LSCA.…”

Section: Kommerell's Aneurysmmentioning

confidence: 99%

A review of the surgical management of right-sided aortic arch aneurysms

Barr

Sepehripour

Jarral

et al. 2016

Interact CardioVasc Thorac Surg

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Aneurysms and dissections of the right-sided aortic arch are rare and published data are limited to a few case reports and small series. The optimal treatment strategy of this entity and the challenges associated with their management are not yet fully investigated and conclusive. We performed a systematic review of the literature to identify all patients who underwent surgical or endovascular intervention for right aortic arch aneurysms or dissections. The search was limited to the articles published only in English. We focused on presentation and critically assessed different management strategies and outcomes. We identified 74 studies that reported 99 patients undergoing surgical or endovascular intervention for a right aortic arch aneurysm or dissection. The median age was 61 years. The commonest presenting symptoms were chest or back pain and dysphagia. Eighty-eight patients had an aberrant left subclavian artery with only 11 patients having the mirror image variant of a right aortic arch. The commonest pathology was aneurysm arising from a Kommerell's diverticulum occurring in over 50% of the patients. Twenty-eight patients had dissections, 19 of these were Type B and 9 were Type A. Eighty-one patients had elective operations while 18 had emergency procedures. Sixty-seven patients underwent surgical treatment, 20 patients had hybrid surgical and endovascular procedures and 12 had totally endovascular procedure. There were 5 deaths, 4 of which were in patients undergoing emergency surgery and none in the endovascular repair group. Aneurysms and dissections of a right-sided aortic arch are rare. Advances in endovascular treatment and hybrid surgical and endovascular management are making this rare pathology amenable to these approaches and may confer improved outcomes compared with conventional extensive repair techniques.

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Section: Kommerell's Aneurysmmentioning

confidence: 99%