Chen C L
Department of Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China.
J Pediatr Surg. 1990 Jul;25(7):795-6. doi: 10.1016/s0022-3468(05)80023-5.
A case of right aortic arch with an aberrant left subclavian artery arising from a Kommerell's diverticulum of the descending thoracic aorta with a left ligamentum arteriosum completing a vascular ring about the trachea and esophagus is presented. A posterolateral left thoracotomy alone is sufficient to provide an excellent exposure for the division of the ligamentum arteriosum and the resection of the Kommerell's diverticulum. Furthermore, the development of a subclavian steal syndrome is prevented by the reimplantation of the divided left subclavian artery into the left common carotid artery through this same incision.
本文报告一例右位主动脉弓，其异常的左锁骨下动脉发自降主动脉的Kommerell憩室，并有左动脉韧带围绕气管和食管形成血管环。单纯左侧后外侧开胸足以充分暴露，便于切断动脉韧带和切除Kommerell憩室。此外，通过同一切口将切断的左锁骨下动脉重新植入左颈总动脉，可预防锁骨下动脉窃血综合征的发生。
