International Multi-Institutional Experience with Presentation and Management of Aortic Arch Laterality in Aberrant Subclavian Artery and Kommerell's Diverticulum

Clare Moffatt, Jonathan Bath, Richard T. Rogers, Jill J. Colglazier, Drew J. Braet, Dawn M. Coleman, Salvatore T. Scali, Martin R. Back, Gregory A. Magee, Anastasia Plotkin, Philip Dueppers, Alexander Zimmermann, Rana O. Afifi, Sophia Khan, Devin Zarkowsky, Gregory Dyba, Michael C. Soult, Kevin Mani, Anders Wanhainen, Carlo SetacciMassimo Lenti, Loay S. Kabbani, Mitchell R. Weaver, Daniele Bissacco, Santi Trimarchi, Jordan B. Stoecker, Grace J. Wang, Zoltan Szeberin, Eniko Pomozi, Hugh A. Gelabert, Shahed Tish, Andrew W. Hoel, Nicholas S. Cortolillo, Emily L. Spangler, Marc A. Passman, Giovanni De Caridi, Filippo Benedetto, Wei Zhou, Yousef Abuhakmeh, Daniel H. Newton, Christopher M. Liu, Giovanni Tinelli, Yamume Tshomba, Airi Katoh, Sammy S. Siada, Manar Khashram, Sinead Gormley, John R. Mullins, Zachary C. Schmittling, Thomas S. Maldonado, Amani D. Politano, Pawel Rynio, Arkadiusz Kazimierczak, Alexander Gombert, Houman Jalaie, Paolo Spath, Enrico Gallitto, Martin Czerny, Tim Berger, Mark G. Davies, Francesco Stilo, Nunzio Montelione, Luca Mezzetto, Gian Franco Veraldi, Mario D'Oria, Sandro Lepidi, Peter Lawrence, Karen Woo*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Aberrant subclavian artery (ASA) with or without Kommerell's diverticulum (KD) is a rare anatomic aortic arch anomaly that can cause dysphagia and/or life-threatening rupture. The objective of this study is to compare outcomes of ASA/KD repair in patients with a left versus right aortic arch. Methods: Using the Vascular Low Frequency Disease Consortium methodology, a retrospective review was performed of patients ≥18 years old with surgical treatment of ASA/KD from 2000 to 2020 at 20 institutions. Results: 288 patients with ASA with or without KD were identified; 222 left-sided aortic arch (LAA), and 66 right-sided aortic arch (RAA). Mean age at repair was younger in LAA 54 vs. 58 years (P = 0.06). Patients in RAA were more likely to undergo repair due to symptoms (72.7% vs. 55.9%, P = 0.01), and more likely to present with dysphagia (57.6% vs. 39.1%, P < 0.01). The hybrid open/endovascular approach was the most common repair type in both groups. Rates of intraoperative complications, death within 30 days, return to the operating room, symptom relief and endoleaks were not significantly different. For patients with symptom status follow-up data, in LAA, 61.7% had complete relief, 34.0% had partial relief and 4.3% had no change. In RAA, 60.7% had complete relief, 34.4% had partial relief and 4.9% had no change. Conclusions: In patients with ASA/KD, RAA patients were less common than LAA, presented more frequently with dysphagia, had symptoms as an indication for intervention, and underwent treatment at a younger age. Open, endovascular and hybrid repair approaches appear equally effective, regardless of arch laterality.

Original languageEnglish (US)
Pages (from-to)23-31
Number of pages9
JournalAnnals of vascular surgery
Volume95
DOIs
StatePublished - Sep 2023

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'International Multi-Institutional Experience with Presentation and Management of Aortic Arch Laterality in Aberrant Subclavian Artery and Kommerell's Diverticulum'. Together they form a unique fingerprint.

Cite this