Mascarenhas Vasco, Marques Hugo, Valentim Hugo, Guerra Adalgisa, Afonso P Diana, Ventura Carlos, Gaspar Augusto
Centro de Imagiologia, Departamento de Medicina Geral e Familiar do Hospital da Luz, Lisboa, Portugal.
Rev Port Cir Cardiotorac Vasc. 2012 Oct-Dec;19(4):217-20.
Aortic vascular anomalies are complex anatomic entities requiring often complex and problematic surgical approaches. The authors report the clinical case of a Kommerell's diverticulum and right-sided aortic arch. Right-sided aortic arch is an uncommon congenital defect of the aorta and it is rare in the setting of an otherwise normal heart. A right-sided aortic arch was described more than two centuries ago. Several classifications of these anomalies have been proposed on the basis of the arrangement of the arch vessels, relationships with the esophagus, or the presence of congenital heart anomalies. In the adult population, a right-sided aortic arch is often asymptomatic, unless aneurismal disease develops. This usually occurs at the level of the take-off of an aberrant left subclavian artery and is known as a Kommerell's diverticulum. In spite of its rarity, this condition is clinically relevant due to the mortality associated with rupture, morbidity caused by compression of mediastinal structures, and complexity of surgery.
主动脉血管异常是复杂的解剖实体,常常需要复杂且有问题的手术方法。作者报告了一例Kommerell憩室合并右侧主动脉弓的临床病例。右侧主动脉弓是一种罕见的主动脉先天性缺陷,在心脏其他方面正常的情况下较为少见。两个多世纪前就已描述过右侧主动脉弓。基于弓血管的排列、与食管的关系或先天性心脏异常的存在,已提出了这些异常的几种分类方法。在成年人群中,右侧主动脉弓通常无症状,除非发生动脉瘤疾病。这通常发生在异常左锁骨下动脉起始处水平,称为Kommerell憩室。尽管这种情况罕见,但由于与破裂相关的死亡率、纵隔结构受压引起的发病率以及手术的复杂性,它在临床上具有重要意义。