Kommerell's Diverticulum, Risk Factor for Aortic Dissection

Nasır, Abdul; Jadoon, Mehmood; Ellis, Peter; Graham, Alastair

doi:10.1111/j.1540-8191.2008.00751.x

Cited by 8 publications

(4 citation statements)

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“…Surgical treatment of aortic disease being associated with different branching patterns has been described mainly by different case reports, addressing Kommerell diverticuli or bovine aortic arches. 15,16,20,21 Our data revealed higher rates of concomitant intervention of the aortic arch in patients with aneurysm who display anomalous branch patterns. Especially patients with a bovine aortic arch undergo hemiarch replacement more frequently than patients without aortic arch anomalies (46% vs 34.6%; P ¼ .023).…”

Section: Discussionmentioning

confidence: 56%

“…In terms of potential associations of aortic arch anomalies and TAD, 2 case reports describe the presence of a Kommerell diverticulum in patients with acute aortic dissections. 15,16 Stone and colleagues 17 addressed treatment options of the right aberrant subclavian artery in a series of 24 patients. They concluded that the presence of a Kommerell diverticulum in these patients correlated with the need for intervention, whereas the presence of aberrant right subclavian artery alone could be safely followed medically.…”

Section: Discussionmentioning

confidence: 99%

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Atypical aortic arch branching variants: A novel marker for thoracic aortic disease

Dumfarth

Chou

Ziganshin

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

110

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Atypical aortic arch branching variants: A novel marker for thoracic aortic disease

Dumfarth

Chou

Ziganshin

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

110

View full text Add to dashboard Cite

show abstract

“…Second, the aberrant right subclavian artery arose directly from the aortic arch at an acute angle. According to the hemodynamic theory, there would be a greater shear force in the bloodstream[12,15]. The high blood flow rate in the aorta had a direct impact on the wall of the aberrant right subclavian artery, and the fragile and easily damaged wall caused by the congenital abnormality aggravated the damage.…”

Section: Discussionmentioning

confidence: 99%

Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome: A case report

Sun¹,

Zhang²,

Zhang³

et al. 2019

WJCC

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BACKGROUNDWe report a rare case of numbness in the right hand, finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and explain the cause of these diseases.CASE SUMMARYThe patient was a 65-year-old woman. She complained of dizziness, numbness and weakness of the right hand for 6 mo. She was diagnosed with bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome by ultrasound, enhanced computed tomography, computed tomography angiography and other examinations. Considering the surgical risks, the patient refused the aberrant right subclavian artery stent implantation and was discharged. We hypothesize that these two kinds of deformity and right subclavian steal syndrome may not occur by accident and result from multiple malformations.CONCLUSIONBilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome is rare. This case reminds interventional radiologists of the possibility of these abnormalities before surgery.

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“…Retrograde dissection of the ascending aorta from the coronary arteries during PCI 5 and from the right common carotid artery during inadvertent Swan-Ganz catheter insertion 6 has been described. It has been associated with pregnancy 7 and Kommerell's diverticulum 8 . However, spontaneous retrograde dissection of the ascending aorta from the descending aorta has no known predisposing factors that would foretell a retrograde propagation of dissection.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous retrograde dissection of ascending aorta from descending thoracic aorta - a case review

Kaul

2011

Perfusion

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A 56-year-old man with sudden onset chest pain, absent right lower limb pulses and ECG changes suggestive of inferior ST elevation MI underwent coronary angiogram through the right radial artery with a view to primary percutaneous coronary intervention (PCI). The left coronary angiogram demonstrated severe proximal stenotic disease in the left anterior descending and circumflex coronary arteries, but the right coronary artery could not be selectively cannulated. An ascending aortogram to visualise the right coronary artery not only failed to demonstrate it, but revealed, instead, a dissection flap in the ascending aorta, arch and descending thoracic aorta, with moderately severe aortic regurgitation. At operation, the patient was found to have an acute dissection of the ascending aorta, arch and descending aorta with an entry tear in the descending aorta below the left subclavian artery origin. Triple coronary artery bypass grafting with re-suspension of the aortic valve, supracoronary replacement of the ascending aorta and hemiarch and transaortic repair of the descending aortic tear was performed. The patient made an uncomplicated recovery, with the re-appearance of right limb pulses. A postoperative magnetic resonance (MR) scan revealed complete thrombosis of the false channel in the residual arch and a considerably shrunken false channel in the descending aorta and no aortic regurgitation. Retrograde dissection of the ascending aorta from the descending aorta has been reported infrequently in the past. We believe the scale of the problem has been underestimated because of the failure to adopt open distal anastomosis routinely in the past and, hence, failure to inspect the arch and the descending aorta routinely, particularly when the intimal tear was not identified in the ascending aorta. Retrograde dissection of the ascending aorta from an intimal tear in the descending aorta, when identified as such, has been managed, either on the principle of exclusion of the tear in the descending aorta by various elephant trunk procedures and their variants or, alternatively, on the principle of excision of the tear by extended one-stage aortic replacement, usually combined with an elephant trunk procedure. Neither of these procedures is widely adopted, owing to procedural, institutional and outcome considerations. We describe a transaortic repair of the intimal tear in the descending aorta with supracoronary interposition graft replacement of the ascending aorta and hemiarch with excellent clinical and radiological result. We also review the diagnostic and therapeutic approaches to this incompletely understood lethal disease.

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Kommerell's Diverticulum, Risk Factor for Aortic Dissection

Cited by 8 publications

References 0 publications

Atypical aortic arch branching variants: A novel marker for thoracic aortic disease

Atypical aortic arch branching variants: A novel marker for thoracic aortic disease

Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome: A case report

Spontaneous retrograde dissection of ascending aorta from descending thoracic aorta - a case review

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