Any information contained in this pdf file is automatically generated from digital material submitted. Extrinsic esophagus compression produced by vascular structures is. Conclusions and relevance kommerell diverticulum, a remnant of the left dorsal arch, is a rare cause of dysphagia. Kommerells diverticulum and aneurysmal rightsided aortic arch. The presence of a rightsided aortic arch, left ductus arteriosus and aberrant left. Right aortic arch with aberrant left subclavian artery from a kommerells diverticulum is a very rare variant of the incomplete vascular ring. Kommerell aneurysms and diverticula are normally repaired in a twostaged thoracotomy procedure in which the descending aorta and. The investigators describe an unusual case of tracheal and esophageal compression by atherosclerotic dilatation of the diverticulum of kommerell associated with a congenital aberrant right subclavian artery, illustrating how agingrelated vascular degenerative disease can modify the clinical manifestations of congenital anomalies in an 84yearold man. Kommerell diverticula occur in some anomalies of the aortic arch system. However planning the strategy of operation is difficult without a 3d imaging. Aberrant right subclavian artery arteria lusoria aneurysm with a. Kommerells diverticulum, which is a rare condition, is a congenital abnormality of the aortic arch. Aberrant right subclavian artery and kommerells diverticulum.
Twentytwo patients underwent repair of aberrant subclavian arteries and associated kommerell diverticulum. A rightsided aortic arch with kommerells diverticulum of. Right aortic arch with kommerells diverticulum is a very rare situation. Before and during world war i, he studied at the schiller gymnasium in berlin 19101920, where he. In the international literature, however, the name of kommerell survives only as an eponym. Dysphagia lusoria caused by kommerell diverticulum revista. This happens when there is pressure on your pharynx and it balloons out. Saccular kommerell aneurysm, a potential pitfall on mdct imaging. The strategy of surgical treatment for kommerells diverticulum has not been established. Kommerell diverticulum radiology reference article. Any information contained in this pdf file is automatically generated from digital. However, vascular causes should be considered in the algorithm when evaluating patients who present with dysphagia, especially when there is compression of the esophagus noted on imaging or examination.
Chest computed tomography angiogram showed a rightsided aortic arch with a left aberrant subclavian artery dilated at its origin kommerell diverticulum. It is an uncommon condition that occurs in association with a left aortic arch. The left cca is the first branch given off by the ascending aorta. B an illustration shows the obliteration of kommerells diverticulum and the aortosubclavian bypass by artificial conduit arrowhead. Aberrant right subclavian artery arsa with kommerells diverticulum, is a rare congenital anomaly of the aortic arch found at postmorten examination with a frequency of 0,5%. Direct origins of the right sca and the right cca from the aortic arch.
Between 1994 and 2004, 6 patients underwent surgery for kommerells diverticulum at our. Aberrant right subclavian artery from an aneurysmal. We present a case of incidentally detected rightsided aortic arch with kommerells diverticulum and aberrant left subclavian artery. The treatment options for aberrant right subclavian artery vary depending on the presence of kommerells diverticulum. Before and during world war i, he studied at the schiller gymnasium in berlin 19101920, where he became a skillful pianist and a prolific composer.
Pdf first described in 1936, the diverticulum of kommerell dok is a dilatation of the. Kommerell diverticulum definition of kommerell diverticulum. This saccular aneurysmal dilation at the origin of aberrant subclavian artery consists of an aneurysm of the thoracic aorta as well as an aneurysmal opening of an aberrant subclavian artery 2, 3. It is a pouch that forms in your pharynx, an area just above your esophagus or swallowing tube. Saccular kommerell aneurysm, a potential pitfall on mdct.
Any information contained in this pdf file is automatically generated from. Burckhard friedrich kommerells scholarly description of the aortic diverticulum that bears his name was published in 1936. A rightsided aortic arch with kommerells diverticulum of the aberrant left subclavian artery presenting with syncope minghsun yang 1, zenchung weng, yuguo weng2, hsiaohuang chang 1division of cardiovascular surgery, department of surgery, taipei veterans general hospital. Aberrant right subclavian artery arsa with kommerell s diverticulum, is a rare congenital anomaly of the aortic arch found at postmorten examination with a frequency of 0,5%. Associated symptoms are caused due to tracheal or esophagus compression. Kommerell aneurysms and diverticula are normally repaired in a twostaged thoracotomy procedure in which the descending aorta and aberrant subclavian. It usually refers to the bulbous configuration of the origin of an aberrant left subclavian artery in the setting of a rightsided aortic arch.
Pdf first described in 1936, the diverticulum of kommerell dok is a dilatation. Kommerell diverticulum and aberrant right subclavian artery. Right aortic arch and kommerells diverticulum repaired. Surgical treatment for kommerells diverticulum sciencedirect.
Pdf vascular ring related to kommerell diverticula. In this lesion the right subclavian artery arises as the fourth branch of the aorta distal to the origin of the left subclavian artery, then comes to the right arm posterior to the esophagous. Texas heart institute journal volume 9, number 2, 2002. Right descending aorta with leftsided kommerell diverticulum, typically giving rise to the left sca, which originates in a kink. Surgical treatment is recommended for symptomatic patients or asymptomatic patients with a large diverticulum. Prenatal diagnosis of vascular ring with right aortic arch dialnet.
There is a common wall that separates the esophagus from the diverticulum pouch. Zenkers diverticulum repair what is zenkers diverticulum. Magnetic resonance is the gold standard for diagnosis. A barium swallow esophagography before surgery shows significant compression of the esophagus by kommerells diverticulum arrow. Arena, md, gerard bruin, md, frcpc, and catherine m. Aberrant right subclavian artery and calcified aneurysm of. The treatment for kommerell diverticulum and aberrant subclavian artery is surgical, with. Burckhard kommerell described an aortic diverticulum for the first time in 1936 in a living patient. We present biographical information about kommerell, as supplied by family members, and comment on the surgical relevance of. In this lesion the right subclavian artery arises as the fourth branch of the aorta distal to the origin of the left subclavian artery, then comes to the right arm. We report a case of a 57yearold man with right aortic arch, kommerells diverticulum, and aberrant left subclavian artery. Right aortic arch, kommerells diverticulum and aberrant left subclavian artery. Cina and colls 7 recommended surgical treatment for aneurysms 3 cm or greater and in ota experience 9 your primary indication was that the diameter of aneurysm was more than 50 mm.