Abstract :

Objectives: The aberrant subclavian artery is among the congenital vascular anomalies of the aortic arch. Aberrant subclavian arteries can be seen in different types and on the right or left side. Aneurysmal dilatation, named Kommerell’s diverticulum, may be seen in the descending thoracic aorta at the origin of the right aberrant subclavian artery. The aim of this study aimed to present our experience with aberrant subclavian artery pathology. Materials and Methods: This was a retrospective review of our experience from two instutitions with 14 patients who had an aberrant subclavian artery between 2015-2021. Seven patients (62.5%) were male, and the median age at the time of surgery was 38.4 months (range: 6 months to 75 years). Patients were either asymptomatic, incidentally diagnosed, or presented with dyspnea and/or dysphagia lusoria. Results: Asymptomatic patients were not interfered. There was no early or late mortality in 6 patients who underwent surgery. Three (50%) patients underwent aberrant right subclavian artery repair through right thoracotomy, two received a hybrid approach due to Kommerell’s diverticulum, and one patient underwent aberrant left subclavian artery repair from left thoracotomy. The median postoperative duration of the intensive care unit and hospital stays were 1 and 6 days, respectively. Patients were followed for a median of 3.6 years (range, 1.2-6.8 years) after intervention. No endoleak was observed in the follow-up of patients who underwent endovascular repair. Conclusion: The data suggest that symptomatic aberrant subclavian artery pathology can be treated safely in selected patients with good early and mid-term results. The right or left side of the aberrant subclavian artery may change the surgical approach. Patients with Kommerell’s diverticulum with a right aberrant subclavian artery can be treated with a hybrid approach using endovascular techniques.