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Hybrid Repair of Kommerell’s D iverticulum

Hybrid Repair of Kommerell’s D iverticulum. Jahanzaib Idrees MD, Suresh Keshavamurthy MD, Sreekumar Subramanian MD, Daniel  G. Clair MD, Lars G. Svensson MD , Eric E. Roselli MD. Heart and Vascular Institute. Kommerrel’s Diverticulum. Kommerrel’s Diverticulum.

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Hybrid Repair of Kommerell’s D iverticulum

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  1. Hybrid Repair of Kommerell’sDiverticulum • JahanzaibIdreesMD, Suresh KeshavamurthyMD,Sreekumar Subramanian MD, Daniel G. Clair MD, Lars G. Svensson MD, Eric E. Roselli MD Heart and Vascular Institute

  2. Kommerrel’sDiverticulum Kommerrel’s Diverticulum • Frequently co-exists with aberrant subclavian artery & right sided aortic arch Ligamentum Arteriosum Completing Vascular ring Right sided Aortic Arch

  3. Objectives • To describe hybrid repair techniques • To evaluate clinical outcomes

  4. Patients August 2005 to October 2010 Mean Age 57 ± 25

  5. Elephant Trunk With Endo Completion N=4 Stage I Stage I I

  6. Frozen Elephant Trunk N=3 Stentgraft delivered antegrade; sutured proximally Posterior view; subclavian coiled + Ascending Subclavian Bypass Ligamentum divided

  7. TEVAR with Cervical Debranching N=3 Right Carotid subclavian bypass Left Carotid subclavian bypass Stent Graft

  8. Subclavian Revascularization

  9. Results • No Mortality • 1 Stroke • Post TEVAR, mild dysarthria and unilateral leg weakness • 2 Type II endoleaks • 1 requiring Subclavianembolization • No paraplegia • No Respiratory failure • No Renal failure • No Reoperation for bleeding

  10. Conclusions Hybrid repair of Kommerell’s diverticulum is safe and effective. Type of intervention is based on patient’s anatomy and co-morbid conditions.

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