{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:46:26Z","timestamp":1792759586923,"version":"4.5.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Kommerell diverticulum (KD) is a rare congenital vascular anomaly often associated with an aberrant subclavian artery (ASCA). Definitive indications for intervention remain unclear. We present open and endovascular (EV) operative outcomes in a large contemporary series and propose a management algorithm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Between 2004 and 2020, 224 patients presented with ASCA and associated KD to our institution. Of the 43 (19.2%) patients who underwent operative repair, 31 (72.1%) had open surgical (OS) repair via thoracotomy and 12 (27.9%) had EV repair. Univariable and bivariable statistical analyses were conducted stratified by approach. The median follow-up time was 5.4\u2009years (IQR, 2.9\u20139.7).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Patients in EV group were older (68 years vs 47 years, P\u2009&amp;lt;\u20090.001) and had larger aneurysms (base diameter 3.2\u2009cm vs 21.5\u2009cm, P\u2009=\u20090.007). All patients with dysphagia lusoria were treated with open surgery (n\u2009=\u200920). Asymptomatic patients with incidentally detected KD (50% vs 16.1%), those with chest or back pain (50% vs 19.4%) and patients who presented with an aortic emergency (25% vs 6.5%) were more likely to be treated endovascularly (P\u2009=\u20090.001). Carotid-to-subclavian bypass was used in 38 (88.4%) patients. There were no operative mortalities. In-hospital mortality was similar between groups (3.2% vs 16.7%, P\u2009=\u20090.121). Mid-term mortality was higher in the EV group [4 (33.8%) vs 0, P\u2009&amp;lt;\u20090.001]. There were 2 (15.4%) postoperative strokes in the EV group. There were no statistically significant differences in other postoperative complications or hospital length of stay between groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>KD can be managed using open or EV approaches with low morbidity and mortality. Treatment strategy should depend on clinical presentation and patient factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab072","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T04:40:29Z","timestamp":1611808829000},"page":"305-311","source":"Crossref","is-referenced-by-count":17,"title":["Outcomes of open and endovascular repair of Kommerell diverticulum"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3622-4818","authenticated-orcid":false,"given":"Jordan P","family":"Bloom","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rizwan Q","family":"Attia","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thoralf M","family":"Sundt","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duke E","family":"Cameron","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8527-9386","authenticated-orcid":false,"given":"Sandeep S","family":"Hedgire","sequence":"additional","affiliation":[{"name":"Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami B","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0393-168X","authenticated-orcid":false,"given":"Eric M","family":"Isselbacher","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunita D","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Fireman Vascular Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J","family":"Kwolek","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Fireman Vascular Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Eagleton","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Fireman Vascular Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahan","family":"Mohebali","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Fireman Vascular Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arminder S","family":"Jassar","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,14]]},"reference":[{"key":"2021080208043039500_ezab072-B1","first-page":"590","article-title":"Verlagerung des Osophagus durch eine abnorm verlaufende Arteria subclavia dextra (arteria lusoria)","volume":"54","author":"Kommerell","year":"1936","journal-title":"Fortschr Roentgenster"},{"key":"2021080208043039500_ezab072-B2","first-page":"E156","article-title":"Taking a new look at Kommerell: recent insights on aortic diverticula","volume":"13","author":"Criado","year":"2016","journal-title":"Vasc Dis Manag"},{"key":"2021080208043039500_ezab072-B3","doi-asserted-by":"publisher","first-page":"673","DOI":"10.2214\/ajr.142.4.673","article-title":"The three types of aortic diverticula","volume":"142","author":"Salomonowitz","year":"1984","journal-title":"American Journal of 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Evaluation of 1378 observations","volume":"380","author":"Molz","year":"1978","journal-title":"Virchows Arch A Pathol Anat Histol"},{"key":"2021080208043039500_ezab072-B7","first-page":"2:275","article-title":"An account of a singular case of obstructed deglutition","author":"Bayford","year":"1794","journal-title":"Mem Med Soc London"},{"key":"2021080208043039500_ezab072-B8","first-page":"e266","article-title":"2010 ACCF\/AHA\/AATS\/ACR\/ASA\/SCA\/SCAI\/SIR\/STS\/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: executive summary: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular 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