Two-stage hybrid repair for a Kommerell diverticulum in a right-sided aortic arch associated with multivessel coronary disease and atrial septal defect

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Two-stage hybrid repair for a Kommerell diverticulum in a right-sided aortic arch associated with multivessel coronary disease and atrial septal defect Hidetake Kawajiri, MD, Katsuhiko Oka, MD, Keiichi Kanda, MD, PhD, Hitoshi Yaku, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 147, Issue 1, Pages 532-534 (January 2014) DOI: 10.1016/j.jtcvs.2013.08.069 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Computed tomography angiography demonstrated a right aortic arch and an aberrant left subclavian artery that originated from a Kommerell diverticulum (arrow). B, Atrial septal defect revealed by transthoracic echocardiography (arrow). C and D, Coronary angiogram showing occlusion of the proximal right coronary artery and severe stenosis of the left main trunk of the coronary artery and left anterior descending artery (arrow). RA, Right atrium; LA, left atrium. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 532-534DOI: (10.1016/j.jtcvs.2013.08.069) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Postoperative computed tomography performed at 34 months showed that the debranching graft (black arrow) and coronary artery bypass graft (white arrow) were patent. B, The endograft comfortably fit the curvature of the aortic arch and no endoleaks or migration were observed. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 532-534DOI: (10.1016/j.jtcvs.2013.08.069) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions