Tsukagoshi Junji, Iba Yutaka, Kurimoto Yoshihiko, Maruyama Ryushi, Yanase Yosuke, Nishioka Naritomo, Masuda Takahiko, Yamada Akira
Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan.
Ann Vasc Dis. 2021 Mar 25;14(1):60-63. doi: 10.3400/avd.cr.20-00129.
Surgical indication and treatment for patients with Kommerell diverticulum and aberrant subclavian artery are still not well established. A patient with esophageal and tracheal compression resulting from these anatomical abnormalities was successfully treated with a hybrid approach of total arch replacement, frozen elephant trunk technique, aberrant left subclavian artery transection, and left subclavian artery reconstruction through median sternotomy. Compressive symptoms were relieved without resecting the enlarged diverticulum. In this case, the importance of preoperative investigation for the main cause of compressive symptoms is illustrated and a novel treatment strategy is outlined.
Kommerell憩室合并迷走锁骨下动脉患者的手术指征及治疗方法仍未完全明确。一名因这些解剖异常导致食管和气管受压的患者，通过正中开胸行全弓置换、“象鼻”技术、切断迷走左锁骨下动脉并重建左锁骨下动脉的杂交手术成功得到治疗。在未切除增大的憩室的情况下，压迫症状得到缓解。该病例说明了术前明确压迫症状主要原因的重要性，并概述了一种新的治疗策略。
