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Case Reports in Vascular Medicine
Volume 2013, Article ID 840804, 3 pages
Case Report

Right Aortic Arch and Kommerell’s Diverticulum Repaired without Reconstruction of Aberrant Left Subclavian Artery

1Division of Cardiovascular Surgery, Shimada General Hospital, Higashi-cho 5-3, Choshi, Chiba 288-0053, Japan
2Department of Cardiovascular Surgery, National Center of Global Health and Medicine, Shinjuku, Tokyo 162-8655, Japan
3Division of Cardiovascular Surgery, Ikegami General Hospital, Ota, Tokyo 146-8531, Japan
4Department of Cardiovascular Surgery, Kawasaki Medical University, Kurashiki, Okayama 701-0192, Japan

Received 18 March 2013; Accepted 8 April 2013

Academic Editors: A. Iyisoy, N. Nighoghossian, G. Pasterkamp, and G. L. Tripepi

Copyright © 2013 Hiroshi Osawa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Right aortic arch with Kommerell’s diverticulum is a very rare situation. Surgical treatment is recommended for symptomatic patients or asymptomatic patients with a large diverticulum. However planning the strategy of operation is difficult without a 3D imaging. We report a case of a 57-year-old man with right aortic arch, Kommerell’s diverticulum, and aberrant left subclavian artery. After a 3D-CT imaging, the patient underwent descending aortic replacement without reconstruction of aberrant left subclavian artery. After operation, there was no signs or symptoms of ischemia of the left arm. If the reconstruction of the aberrant subclavian artery was too difficult, closing its orifice is an acceptable decision. It has been found advantageous because of a decrease blood loss and a shorter cardiopulmonary bypass duration. If an ischemia of the arm is noticed, additional reconstruction will have to be considered. 3D-CT imaging was very useful to have a proper orientation and plan for the operative strategy.