{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:18:52Z","timestamp":1788261532068,"version":"build-2803163510"},"reference-count":32,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Cardiovasc. Dev. Dis.","JCDD"],"abstract":"<jats:p>Background: Right-sided aortic arch with Kommerell diverticulum (RAA-KD) has complex three-dimensional anatomy. Methods: We retrospectively analyzed computed tomography angiography data from 65 adults with RAA-KD using centerline-based reconstruction. Patients were stratified by conventional maximal KD diameter (DKDmax) into &lt;55 mm (n = 38) and \u226555 mm (n = 27) groups. Age associations, adjusted group differences, and continuous associations with centerline-derived KD diameter at maximal cross-sectional area (D10) were examined. Results: After sex adjustment and false-discovery-rate correction, all aortic diameters increased with age; the ascending aorta, arch, and descending thoracic aorta also elongated, whereas aortic isthmus (L4) and KD (L5) lengths were not age-associated. After age and sex adjustment and false-discovery-rate correction, diameters of the ascending aorta, aortic arch, and descending thoracic aorta (D2\u2013D8), as well as KD-related diameters (D9\u2013D12), remained larger in the \u226555 mm group; L4 was shorter and L5 longer. In continuous models, D10 was positively associated with all non-KD diameters, most strongly with the adjacent proximal descending aorta (D7), and independently associated with shorter L4 (B = \u22120.548; 95% CI, \u22120.828 to \u22120.268) and longer L5 (B = 0.639; 95% CI, 0.412\u20130.866; both p &lt; 0.001). Conclusions: RAA-KD demonstrates generalized age-associated thoracic aortic enlargement and localized KD-associated remodeling. Comprehensive three-dimensional assessment may inform evaluation of the adjacent aorta and proximal sealing zone for thoracic endovascular aortic repair.<\/jats:p>","DOI":"10.3390\/jcdd13090427","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:32:18Z","timestamp":1788258738000},"page":"427","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Three-Dimensional Thoracic Aortic Remodeling Associated with Kommerell Diverticulum Enlargement in Adults with a Right-Sided Aortic Arch: A Quantitative CTA Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0860-6894","authenticated-orcid":false,"given":"Xiaolong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Wuhan No. 1 Hospital, 215 Zhongshan Avenue, Qiaokou District, Wuhan 430022, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Jiehua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha 410011, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Hao","family":"He","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha 410011, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha 410011, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Chenzi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha 410011, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Chang","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha 410011, China"},{"name":"Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jvs.2003.07.021","article-title":"Kommerell\u2019s diverticulum and right-sided aortic arch: A cohort study and review of the literature","volume":"39","author":"Althani","year":"2004","journal-title":"J. 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