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/bf02483000

Cited by 3 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One patient developed paraplegia after surgery (4%). 30 The aberrant subclavian artery was ligated or occluded in 13 cases [12][13][14][15]17,18,21,24,27,28,33,34 and was reconstructed with an aortosubclavian bypass or with an inclusion technique in 7 16,19,32,35 and with a subclavian-carotid transposition in 5. 8,11 In two patients the description of the management of the aberrant subclavian artery was unclear.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…8,11 In two patients the description of the management of the aberrant subclavian artery was unclear. 26,30 A partial cardiopulmonary bypass was used in 8 patients, 10,17,19,22,24,27,30,32 a temporary brachiofemoral bypass in 1, 23 deep hypothermia and circulatory arrest in 6, 8,13,15,26,32 a clamp-and-go technique in 6, 12,14,16,21,35 and endovascular repair in one. 34 In seven patients the operative description did not specify if circulatory support was used.…”

Section: Review Of the Literaturementioning

confidence: 99%

See 1 more Smart Citation

Kommerell's diverticulum and right-sided aortic arch: a cohort study and review of the literature

Cinà

Al-Thani

Pasenau

et al. 2004

Journal of Vascular Surgery

361

339

View full text Add to dashboard Cite

We report four consecutive cases of Kommerell's aneurysm of an aberrant left subclavian artery in patients with a right-sided aortic arch and the results of a systematic review of the literature. In our cohort of patients, three had an aneurysm limited to the origin of the aberrant subclavian artery, causing dysphagia and cough, and one had an aneurysm involving also the distal arch and the entire descending thoracic aorta, causing compression of the right main-stem bronchus. A left subclavian-to-carotid transposition was performed in association with the intrathoracic procedure, and a right thoracotomy was used in all patients. One of the patients underwent surgery with deep hypothermia and circulatory arrest, and the others with the adjunct of a left-heart bypass. The repair was accomplished with an interposition graft in two patients and with endoaneurysmorrhaphy in the others. The postoperative course was complicated by respiratory failure and prolonged ventilation in one patient, and one patient died because of severe pulmonary emboli. The survivors are alive and well at a follow-up of 1 to 3 years. Only 32 cases of right-sided aortic arch with an aneurysm of the aberrant subclavian artery have been reported: 12 were associated with aortic dissection, and 2 presented with rupture. Surgical repair was accomplished in 29 patients. A number of operative strategies were described: right thoracotomy, bilateral thoracotomy, left thoracotomy with sternotomy, sternotomy with right thoracotomy, and left thoracotomy. In only 12 cases was the subclavian artery reconstructed. We believe that a right thoracotomy provides good exposure and avoids the morbidity associated with bilateral thoracotomy or sternotomy and thoracotomy. We feel that a left subclavian-to-carotid transposition completed before the thoracic approach revascularizes the subclavian distribution without increasing the complexity of the intrathoracic procedure.

show abstract

Section: Review Of the Literaturementioning

confidence: 99%

Section: Review Of the Literaturementioning

confidence: 99%

Kommerell's diverticulum and right-sided aortic arch: a cohort study and review of the literature

Cinà

Al-Thani

Pasenau

et al. 2004

Journal of Vascular Surgery

361

339

View full text Add to dashboard Cite

show abstract

“…[4][5][6] Blunt or penetrating trauma often predisposes to the formation of a pseudoaneurysm. 4,5 In our patient, thoracic trauma 25 years prior to admission seemed to have caused the development of a true aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Intrathoracic Aneurysm of the Innominate and Right Subclavian Arteries: Report of a Case

et al. 2001

View full text Add to dashboard Cite

Aneurysms of the innominate and subclavian arteries are uncommon but associated with high mortality rates. We report herein the case of a 45-year-old man who presented with facial anhidrosis that developed several years after blunt thoracic trauma, in whom an aneurysm involving the innominate and subclavian arteries was revealed by preoperative examinations. Resection of the aneurysm and reconstruction from the ascending aorta to both the subclavian and common carotid arteries using a bifurcated graft was successfully performed without brain perfusion. Although the left posterior cerebral artery, which was not manipulated during surgery, became occluded, it was recanalized by thrombolysis. The patient was discharged in good health and has remained well since.

show abstract

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

Barr

Sepehripour

Jarral

et al. 2016

Interact CardioVasc Thorac Surg

View full text Add to dashboard Cite

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.

show abstract

An aberrant left subclavian artery aneurysm with right aortic arch: Report of a case

Cited by 3 publications

References 4 publications

Kommerell's diverticulum and right-sided aortic arch: a cohort study and review of the literature

Kommerell's diverticulum and right-sided aortic arch: a cohort study and review of the literature

Intrathoracic Aneurysm of the Innominate and Right Subclavian Arteries: Report of a Case

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

Contact Info

Product

Resources

About