Hybrid Treatment for Ruptured Diverticulum of Kommerell: A Minimally Invasive Option

Although aberrant right subclavian artery is the commonest aortic arch anomaly, it is a rare entity in clinical practice. While mostly asymptomatic, the rupture of an aneurysm of an aberrant right subclavian artery or Kommerell's diverticulum can be life threatening. A conventional open surgical approach involving sternotomy and resection of the abnormal vessels under circulatory support carries significant morbidity and mortality. We report a case of a ruptured diverticulum of Kommerell that was successfully treated with a hybrid debranching surgery, Amplatzer device embolization of the subclavian vessels, and thoracic aortic endovascular stenting.