Contralateral Thoracotomy With Extracorporeal Circulation for Reoperative Resection of a Kommerell Diverticulum

World J Pediatr Congenit Heart Surg. 2024 Mar;15(2):242-245. doi: 10.1177/21501351231224385. Epub 2024 Feb 20.

Abstract

Reoperative vascular ring surgery is uncommon. Standard redo ipsilateral thoracotomy may present technical challenges and risks. We describe a patient with right aortic arch, aberrant left subclavian artery, and a Kommerell diverticulum in whom previous vascular ring division via left thoracotomy did not relieve dysphagia. Three years after the unsuccessful operation, left subclavian-carotid transposition via supraclavicular incision followed by resection of the Kommerell diverticulum via right thoracotomy with extracorporeal circulation relieved symptoms. Contralateral thoracotomy with extracorporeal circulation provides a safe, alternative approach to redo ipsilateral thoracotomy for resection of a symptomatic Kommerell diverticulum. We review the literature on the incidence, surgical indications, and operative approaches to manage symptoms from a Kommerell diverticulum.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aorta, Thoracic / surgery
  • Cardiovascular Abnormalities* / surgery
  • Diverticulum* / diagnosis
  • Extracorporeal Circulation
  • Heart Defects, Congenital* / surgery
  • Humans
  • Subclavian Artery / surgery
  • Thoracotomy
  • Vascular Ring* / surgery