Pdf first described in 1936, the diverticulum of kommerell dok is a dilatation of the. B an illustration shows the obliteration of kommerells diverticulum and the aortosubclavian bypass by artificial conduit arrowhead. Aberrant right subclavian artery arsa with kommerell s diverticulum, is a rare congenital anomaly of the aortic arch found at postmorten examination with a frequency of 0,5%. Dysphagia lusoria caused by kommerell diverticulum revista. Conclusions and relevance kommerell diverticulum, a remnant of the left dorsal arch, is a rare cause of dysphagia. Kommerell aneurysms and diverticula are normally repaired in a twostaged thoracotomy procedure in which the descending aorta and aberrant subclavian. Kommerells diverticulum and aneurysmal rightsided aortic arch. It is an uncommon condition that occurs in association with a left aortic arch. Right aortic arch and kommerells diverticulum repaired. A rightsided aortic arch with kommerells diverticulum of the aberrant left subclavian artery presenting with syncope minghsun yang 1, zenchung weng, yuguo weng2, hsiaohuang chang 1division of cardiovascular surgery, department of surgery, taipei veterans general hospital.
Any information contained in this pdf file is automatically generated from. We present a case of incidentally detected rightsided aortic arch with kommerells diverticulum and aberrant left subclavian artery. Aberrant right subclavian artery and calcified aneurysm of. In this lesion the right subclavian artery arises as the fourth branch of the aorta distal to the origin of the left subclavian artery, then comes to the right arm. Right aortic arch with kommerells diverticulum is a very rare situation. Aberrant right subclavian artery arsa with kommerells diverticulum, is a rare congenital anomaly of the aortic arch found at postmorten examination with a frequency of 0,5%.
Right aortic arch, kommerells diverticulum and aberrant left subclavian artery. Kommerell diverticulum definition of kommerell diverticulum. Prenatal diagnosis of vascular ring with right aortic arch dialnet. However, vascular causes should be considered in the algorithm when evaluating patients who present with dysphagia, especially when there is compression of the esophagus noted on imaging or examination.
There is a common wall that separates the esophagus from the diverticulum pouch. Chest computed tomography angiogram showed a rightsided aortic arch with a left aberrant subclavian artery dilated at its origin kommerell diverticulum. Pdf first described in 1936, the diverticulum of kommerell dok is a dilatation. Magnetic resonance is the gold standard for diagnosis. We present biographical information about kommerell, as supplied by family members, and comment on the surgical relevance of. Extrinsic esophagus compression produced by vascular structures is. Zenkers diverticulum repair what is zenkers diverticulum. Burckhard friedrich kommerells scholarly description of the aortic diverticulum that bears his name was published in 1936. Saccular kommerell aneurysm, a potential pitfall on mdct. Pdf vascular ring related to kommerell diverticula. The investigators describe an unusual case of tracheal and esophageal compression by atherosclerotic dilatation of the diverticulum of kommerell associated with a congenital aberrant right subclavian artery, illustrating how agingrelated vascular degenerative disease can modify the clinical manifestations of congenital anomalies in an 84yearold man. Any information contained in this pdf file is automatically generated from digital material submitted. Cina and colls 7 recommended surgical treatment for aneurysms 3 cm or greater and in ota experience 9 your primary indication was that the diameter of aneurysm was more than 50 mm.
Burckhard kommerell described an aortic diverticulum for the first time in 1936 in a living patient. Aberrant right subclavian artery and kommerells diverticulum. Before and during world war i, he studied at the schiller gymnasium in berlin 19101920, where he. In this lesion the right subclavian artery arises as the fourth branch of the aorta distal to the origin of the left subclavian artery, then comes to the right arm posterior to the esophagous. It is a pouch that forms in your pharynx, an area just above your esophagus or swallowing tube.
Direct origins of the right sca and the right cca from the aortic arch. The treatment options for aberrant right subclavian artery vary depending on the presence of kommerells diverticulum. Right aortic arch with aberrant left subclavian artery from a kommerells diverticulum is a very rare variant of the incomplete vascular ring. A rightsided aortic arch with kommerells diverticulum of. Aberrant right subclavian artery arteria lusoria aneurysm with a. Right descending aorta with leftsided kommerell diverticulum, typically giving rise to the left sca, which originates in a kink. Associated symptoms are caused due to tracheal or esophagus compression. Aberrant right subclavian artery from an aneurysmal. Surgical treatment for kommerells diverticulum sciencedirect. Twentytwo patients underwent repair of aberrant subclavian arteries and associated kommerell diverticulum. Saccular kommerell aneurysm, a potential pitfall on mdct imaging. We report a case of a 57yearold man with right aortic arch, kommerells diverticulum, and aberrant left subclavian artery.
Kommerells diverticulum, which is a rare condition, is a congenital abnormality of the aortic arch. The treatment for kommerell diverticulum and aberrant subclavian artery is surgical, with. Kommerell diverticulum and aberrant right subclavian artery. A barium swallow esophagography before surgery shows significant compression of the esophagus by kommerells diverticulum arrow. Texas heart institute journal volume 9, number 2, 2002.
Before and during world war i, he studied at the schiller gymnasium in berlin 19101920, where he became a skillful pianist and a prolific composer. Between 1994 and 2004, 6 patients underwent surgery for kommerells diverticulum at our. It usually refers to the bulbous configuration of the origin of an aberrant left subclavian artery in the setting of a rightsided aortic arch. Arena, md, gerard bruin, md, frcpc, and catherine m. This saccular aneurysmal dilation at the origin of aberrant subclavian artery consists of an aneurysm of the thoracic aorta as well as an aneurysmal opening of an aberrant subclavian artery 2, 3. In the international literature, however, the name of kommerell survives only as an eponym. This happens when there is pressure on your pharynx and it balloons out. The left cca is the first branch given off by the ascending aorta. Kommerell aneurysms and diverticula are normally repaired in a twostaged thoracotomy procedure in which the descending aorta and. Kommerell diverticulum radiology reference article. The presence of a rightsided aortic arch, left ductus arteriosus and aberrant left. However planning the strategy of operation is difficult without a 3d imaging. Kommerell diverticula occur in some anomalies of the aortic arch system.36 1309 233 1413 444 607 1108 1337 1508 950 1363 1101 922 393 288 783 1096 963 664 4 966 945 1097 807 11 1297 989 420 285 1441 1041 618 246 575 1095 755 731 838 1493 1437 232 754 211 820 256 627