Aberrant Left Subclavian Artery with Kommerell’s Diverticulum And Right Sided Aortic Arch: Hybrid Approach

Author(s): Juliette Strella, Quentin Langouet, Etienne Marchand, Julien Pucheux, Antoine Legras, Robert Martinez

A 58 years-old woman presented a rare right-sided aortic arch with an aberrant left subclavian retro-esophageal artery, originates from Kommerell’s diverticulum. After left subclavian to carotid transposition, we implanted a thoracic endoprosthesis under ventricular fibrillation. Type IA symptomatic proximal endoleak was treated with a second endograft a week later. We shared here technical aspects and challenges of endovascular management, including precise preoperative imaging (CT angiography, lymphangio-MRI), the need of a hybrid operative room, conformable endoprosthesis and right ventricle overstimulation.