[Successful surgical treatment for distal arch aneurysm involving an aberrant right subclavian artery].

A 68-year-old woman with an aneurysm of the distal arch involving an aberrant right subclavin artery was surgically treated successfully. Computed tomography suggested distal arch aneurysm with the abnormal branching of the arch vessels, which was confirmed as an aberrant right subclavian artery (ARSA) by angiogram. ARSA originated from Kommerell's aortic diverticulum and its orifice developed an aneurysmal change, which severely compressed esophagus and was thought to be the cause of preoperative dysphagia. Distal arch reconstruction was performed with woven Dacron graft using retrograde cerebral perfusion technique under deep hypothermia. Esophageal compression was satisfactorily released by resection of the aneurysm of ARSA which was reconstructed with the same material. Dysphagia disappeared postoperatively. Esophagogram showed no stenosis, and angiogram indicated successful distal arch and ARSA reconstructions.