Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2023; 11(33): 8038-8043
Published online Nov 26, 2023. doi: 10.12998/wjcc.v11.i33.8038
Carotid-subclavian bypass and endovascular aortic repair of Kommerell’s diverticulum with aberrant left subclavian artery: A case report
Wajeehullahi Akilu, Yi Feng, Xiao-Xue Zhang, Shi-Liang Li, Xian-Tao Ma, Min Hu, Cai Cheng
Wajeehullahi Akilu, Yi Feng, Xiao-Xue Zhang, Shi-Liang Li, Xian-Tao Ma, Min Hu, Cai Cheng, Division of Cardiothoracic Surgery and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: All authors contributed equally in writing the paper; all authors have read and approved the manuscript.
Informed consent statement: Informed written consent was taken from the patient.
Conflict-of-interest statement: There was no conflict of interest declared by the authors.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wajeehullahi Akilu, Master's Student, Division of Cardiothoracic Surgery and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. 2838164393@qq.com
Received: August 10, 2023
Peer-review started: August 10, 2023
First decision: August 30, 2023
Revised: September 14, 2023
Accepted: November 10, 2023
Article in press: November 10, 2023
Published online: November 26, 2023
Processing time: 105 Days and 15.5 Hours
Abstract
BACKGROUND

Kommerell’s diverticulum (KD) with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it (35% of case study). There are three types of aortic arch diverticulum. Even literature concerning the treatment options are limited.

CASE SUMMARY

We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery. We conducted a total endovascular repair procedure, which is innovative and will spread more light in the medical world. Our patient has no past medical history and is a non-smoker and non-alcoholic. Patient presented with shortness of breath, chest pain and dizziness for six months. Blood tests were done and computerized tomography (CT) angiogram of the chest confirmed the diagnosis, illustrating showed a 3.9 cm KD. On Day 1, the CT angiogram showed mild dilatation of the thoracic aorta, adjacent esophagus, trachea was compressed and displaced. Surgery was planned as the treatment modality. Carotid-Subclavian artery bypass and endovascular aortic repair was conducted. We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery. Haemostasis was secured and wounds were closed. Protamine was administered and patient was shifted to intensive care unit. Post-operative, patient responded favorably and was discharged. Regular follow-up is done.

CONCLUSION

The procedure we performed is novel. This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted, thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.

Keywords: Kommerell’s diverticulum; Left common carotid artery; Aberrant left subclavian artery; Carotid-subclavian bypass; Medtronic stent catheter endovascular repair; Case report

Core Tip: Kommerell’s diverticulum with aberrant left subclavian artery is an infrequent congenital deformity. Research, and literature about its treatment options is minimal. We present a case report of a 50-year-old male with no comorbidities, with Kommerell’s diverticulum in the right aortic arch with aberrant left subclavian artery. The patient presented with shortness of breath, chest pain and dizziness for six months. Blood tests and a computerized tomography angiogram confirmed the diagnosis. Carotid-subclavian artery bypass and endovascular aortic repair, using a Dacron graft was conducted, which is an innovative procedure, shedding more light on it. Post-operatively, the patient responded favorably.