Aortopexy With Plication of Kommerell Diverticulum Is an Effective Alternative to Diverticulum Resection and Reimplantation of the Aberrant Left Subclavian Artery for Surgical Management of Vascular Rings in Children

Authors

• Adegbemisola Aregbe Perkins
• Ana-Lucia Tomescu
• Christopher J Knott-Craig
• Umar Boston
• Thomas Spentzas
• Karthik Vaidyanathan Ramakrishnan

Language

English

Publication Date

7-1-2025

Journal

World Journal for Pediatric and Congenital Heart Surgery

DOI

10.1177/21501351251329912

PMID

40208045

PMCID

PMC12146880

PubMedCentral® Posted Date

4-10-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background

Right aortic arch with an aberrant left subclavian artery arising from a Kommerell diverticulum is the most common form of vascular ring. We report the outcomes of plication and pexy of the diverticulum in addition to division of the left-sided ligamentum to treat this lesion in children.

Methods

Forty-four patients were included in the study; 22 patients underwent division of the ligamentum arteriosum alone, while the other half underwent plication and/or pexy of the Kommerell diverticulum in addition to division of the ligamentum. The primary outcome of interest was reintervention for persistent symptoms following the initial operation. The other outcome studied was symptom relief on follow-up.

Results

The baseline characteristics were similar between the two groups. There was no difference in the ratio of the size of the Kommerell diverticulum to the size of the left subclavian artery between the groups (1.6 vs 1.8, P = .22). The incidence of reoperation was similar in both groups (5% in each group, P = 1); 7/22 (32%) had persistent symptoms after ligamentum division alone, while only 1/22 (5%) had persistent symptoms after plication and/or pexy (P = .05).

Conclusion

Plication of the Kommerell diverticulum with pexy along with division of the ligamentum arteriosum is an effective alternative for treatment of right aortic arch with an aberrant left subclavian artery arising from the diverticulum.

Keywords

Humans, Subclavian Artery, Male, Female, Aorta, Thoracic, Child, Preschool, Infant, Vascular Ring, Cardiovascular Abnormalities, Diverticulum, Child, Retrospective Studies, Treatment Outcome, Vascular Surgical Procedures, Replantation, Aneurysm, Reoperation, Deglutition Disorders, vascular ring, Kommerell diverticulum, aortopexy, ligamentum arteriosum

Published Open-Access

yes

Recommended Citation

Perkins, Adegbemisola Aregbe; Tomescu, Ana-Lucia; Knott-Craig, Christopher J; et al., "Aortopexy With Plication of Kommerell Diverticulum Is an Effective Alternative to Diverticulum Resection and Reimplantation of the Aberrant Left Subclavian Artery for Surgical Management of Vascular Rings in Children" (2025). Faculty, Staff and Student Publications. 4267.
https://digitalcommons.library.tmc.edu/uthmed_docs/4267