{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:08:31Z","timestamp":1779527311609,"version":"3.53.1"},"reference-count":6,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":142,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Vascular Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Congenital anomalies of the aortic arch often lead to tracheoesophageal compression during childhood. Occasionally, symptoms may not emerge until adulthood, appearing for the first time at any age due to age\u2010related or pathological dilation of the aortic segments. The oldest patient described with symptoms at the onset was 76 years old. Surgical intervention is complex and poses challenges. This case study describes a patient with a right mirror\u2010image branching aortic arch, Kommerell\u2032s diverticulum, and a ligamentum arteriosum originating from the diverticulum. The patient first experienced symptoms of tracheoesophageal compression at 57 years of age. Initial treatment at another hospital, which involved division of the ligamentum and incomplete resection of the diverticulum with its fixation to the chest wall, did not alleviate symptoms. Successful off\u2010pump resurgery was performed through a sternotomy, which included complete resection of Kommerell\u2032s diverticulum and direct closure of the aorta without the use of a patch. Additionally, the left brachiocephalic artery was repositioned away from the tracheoesophageal complex. External skin surface cooling to 30\u00b0C\u201331\u00b0C in the esophagus facilitated safe clamping of the left brachiocephalic artery during the transfer. This case demonstrates successful exposure of Kommerell\u2032s diverticulum through sternotomy and the potential to avoid extracorporeal circulation during clamping of the brachiocephalic trunk by utilizing systemic hypothermia with external cooling.<\/jats:p>","DOI":"10.1155\/crvm\/6292815","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T08:39:39Z","timestamp":1779525579000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Kommerell\u2032s Diverticulum Resection With Left Brachiocephalic Artery Transfer in an Adult With Tracheoesophageal Compression: Off\u2010Pump Sternotomy With External Skin Cooling"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6626-4573","authenticated-orcid":false,"given":"Michael","family":"Malyshev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Safuanov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Malyshev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Sinyukov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrey","family":"Rostovykh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Rostovykh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladlena","family":"Trushina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey","family":"Malyshev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"e_1_2_8_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.06.093"},{"key":"e_1_2_8_2_2","first-page":"106","article-title":"Vascular Tracheobronchial Compression Syndrome in Adults: A Review","volume":"36","author":"Kanabuchi K.","year":"2011","journal-title":"Tokai Journal of Experimental and Clinical Medicine"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.04.097"},{"key":"e_1_2_8_4_2","first-page":"411","article-title":"Treatment of Symptomatic Vascular Rings in the Elderly","volume":"32","author":"Hardin R. 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