Baev B, Nachev G, Chirkov A
Khirurgiia (Sofiia). 1995;48(1):48-50.
Reports on the surgical management of the vascular ring formed by the right aortic arch with aberrant retroesophageal left subclavian artery and left ligamentum arteriosum are relatively few. The authors present a case of a thirty-three-year old woman with cough, dysphonia and stridor without dysphagia. Surgical management which was performed through a bilateral thoracotomy with transversal sternotomy, included division of the ligamentum arteriosum and of the aberrant left subclavian artery and suture of the latter. There was no need to resect the Kommerell's diverticulum, because of lack of any dysphagia despite of the well documented severe compression of the esophagus. The authors experience proved that in difficult cases the bilateral thoracotomy and transversal sternotomy is an useful approach to perform complete surgical repair of this abnormality.
关于由右位主动脉弓伴食管后左锁骨下动脉异常及左动脉韧带形成的血管环的外科治疗报道相对较少。作者报告了一例33岁女性病例,该患者有咳嗽、声音嘶哑和喘鸣,但无吞咽困难。通过双侧开胸及横向胸骨切开术进行的外科治疗,包括切断动脉韧带和异常的左锁骨下动脉,并对后者进行缝合。尽管食管有明确的严重受压,但由于没有吞咽困难,因此无需切除Kommerell憩室。作者的经验证明,在困难病例中,双侧开胸及横向胸骨切开术是对这种异常进行完全手术修复的一种有效方法。