Published in:
01-10-2018 | Anatomic Variations
Crossed pulmonary arteries as additional cause of dysphagia in association with right aortic arch and Kommerell diverticulum
Authors:
Salma El Batti, Iannis Ben Abdallah, Pierre Julia, Jean-Marc Alsac, Pascal Vouhé
Published in:
Surgical and Radiologic Anatomy
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Issue 10/2018
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Abstract
We describe an uncommon association of crossed pulmonary arteries and a right aortic arch with a Kommerell diverticulum and a left ligamentum arteriosum, resulting in disabling dysphagia in a 33-year-old woman. First, endovascular exclusion of the Kommerell diverticulum was performed using a thoracic stent graft, associated with left subclavian–carotid transposition. Second, open aneurysmorrhaphy and division of the left ligamentum arteriosum allowed a proper release of the oesophageal compression. Dysphagia completely disappeared in the postoperative course. Control computed tomography angiography at 6-month follow-up showed a satisfactory hybrid repair. A complete understanding of the combined effects of these two anatomical variations on oesophageal compression led to a suitable surgical management.