Concomitant Repair of Vascular Ring With Kommerell’s Diverticulum and Ventricular Septal Defect

Min Namkoong, Do Yeoun Kim, Cheul Lee

Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Korea

Background : Vascular ring with Kommerell’s diverticulum (KD) is a rare congenital cardiac anomaly and its surgical management is controversial. Some prefer resection of the KD in addition to simple division of the ring to completely improve symptoms of tracheal or esophageal compression and to prevent late complications of the KD itself.

Methods : We report a case of concomitant repair of vascular ring with KD and ventricular septal defect (VSD) in a 5-year-old boy with a symptom of dysphagia. The vascular ring was formed by right aortic arch, retroesophageal left subclavian artery (LSCA) originating from KD, and left ligamentum. Echocardiography revealed a subarterial VSD with a prolapsed right coronary cusp of the aortic valve.

Results : Surgery was performed through a median sternotomy. The ligamentum was divided and the VSD was closed. The KD was resected and the LSCA was transferred to left common carotid artery. Postoperative course was uneventful. The symptom of dysphagia disappeared. Postoperative computed tomography showed patent LSCA and postoperative echocardiography showed no VSD leak.

Conclusion : In patients with intracardiac anomalies and vascular ring formed by right aortic arch, retroesophageal LSCA originating from KD, and left ligamentum, concomitant repair of intracardiac anomalies and vascular ring with KD resection and LSCA reimplantation through a median sternotomy is feasible and can be a good option.

첨부파일 : CT.zip

책임저자: Cheul Lee

Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Korea

발표자: Min Namkoong, E-mail : mini1293@naver.com