• Shinya Takahashi, Kazumasa Orihashi, Kenji Okada, Katsuhiko Imai, Taiichi Takasaki, Naomichi Uchida, and Taijiro Sueda.
• Division of Clinical Medical Science, Department of Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: shiny@mte.biglobe.ne.jp.
• Ann Vasc Surg. 2014 May 1;28(4):1037.e15-9.

AbstractIn this article, we report the case of a 68-year-old woman who presented with shortness of breath. Respiratory function tests showed a slightly obstructive physiology. Computed tomography (CT) results revealed an aberrant left subclavian artery and a Kommerell diverticulum arising from a right-sided aortic arch that was compressing the trachea and the surrounding tissues. A median sternotomy was performed with the patient under circulatory arrest with moderate hypothermia, and a transaortic stent graft was inserted to exclude the Kommerell diverticulum. The aberrant left subclavian artery was ligated and an axillo-axillar bypass was constructed. Postoperative CT showed complete exclusion of the Kommerell diverticulum without an endoleak. The patient's breathing difficulty was resolved, and she was discharged uneventfully. This procedure should be considered as an alternative strategy for exclusion of Kommerell diverticulum.Copyright © 2014 Elsevier Inc. All rights reserved.

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