Treatment of Kommerell's diverticulum in rare aberrant aortic arch anatomy.

A Kommerell's diverticulum (KD) is a saccular aneurysmal outpouching at the origin of an aberrant subclavian artery. Due to a lack of data in the literature, there are no standardized guidelines for management of KD, and the diverse presentation of associated aberrant anatomy complicates evaluating the best modality of treatment. We present a 74-year-old woman who had a uniquely aberrant aortic arch with an aberrant retroesophageal right subclavian artery associated with a KD and a saccular aneurysm off the left subclavian artery who was treated via a hybrid approach, demonstrating the feasibility of this treatment modality in a patient with unique aberrant arch anatomy.