Hybrid Repair of Kommerell’s Diverticulum

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Presentation transcript:

Hybrid Repair of Kommerell’s Diverticulum Jahanzaib Idrees MD, Suresh Keshavamurthy MD, Sreekumar Subramanian MD, Daniel G. Clair MD, Lars G. Svensson MD, Eric E. Roselli MD Title slide is intended to be the first slide of your presentation. You can edit the Title and subtitle on this slide to reflect your own information. The title should be the same as your Abstract title. A title slide will be provided for Research Day which may include your photograph. Heart and Vascular Institute 1

Kommerrel’s Diverticulum Frequently co-exists with aberrant subclavian artery & right sided aortic arch Ligamentum Arteriosum Completing Vascular ring Right sided Aortic Arch

Objectives To describe hybrid repair techniques To evaluate clinical outcomes

Patients N=10 August 2005 to October 2010 Mean Age 57 ± 25 Elephant Trunk with Endo completion N=4 Frozen Elephant Trunk N=3 TEVAR with Cervical Debranching N=3

Elephant Trunk With Endo Completion Stage I Stage I I

+ Ascending Subclavian Bypass Frozen Elephant Trunk N=3 Stentgraft delivered antegrade; sutured proximally Posterior view; subclavian coiled + Ascending Subclavian Bypass Ligamentum divided

TEVAR with Cervical Debranching Right Carotid subclavian bypass Left Carotid subclavian bypass Stent Graft

Subclavian Revascularization C-S Bypass Asc-S Bypass Unilateral (N=6) 4 2 Bilateral (N=4) 3 1 Timing N Preoperative 4 Intraoperative 3 Postoperative

Results No Mortality 1 Stroke Post TEVAR, mild dysarthria and unilateral leg weakness 2 Type II endoleaks 1 requiring Subclavian embolization No paraplegia No Respiratory failure No Renal failure No Reoperation for bleeding

Conclusions Hybrid repair of Kommerell’s diverticulum is safe and effective. Type of intervention is based on patient’s anatomy and co-morbid conditions.