{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:23:56Z","timestamp":1791419036857,"version":"4.3.3"},"reference-count":20,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Kommerell\u2019s diverticulum is a rare vascular anomaly characterized as an outpouch at the onset of an aberrant subclavian artery. In the variant of a right-sided aortic arch, the trachea and esophagus are enclosed dorsally by the arch. In the configuration of an aberrant left subclavian artery, a Kommerell\u2019s diverticulum and persisting ductus arteriosus or ductal ligament enclose the lateral side, forming a vascular ring which may result in (symptomatic) esophageal or tracheal compression. Spontaneous rupture of an aneurysmatic Kommerell\u2019s diverticulum has also been reported. Due to the rarity of this condition and underreporting in the literature, the clinical implications of a Kommerell\u2019s diverticulum are not well defined. Case summary: We describe seven consecutive adult patients with a right-sided aortic arch and an aberrant course of the left subclavian artery (arteria lusoria), and a Kommerell\u2019s diverticulum, diagnosed in our tertiary hospital. One patient had severe symptoms related to the Kommerell\u2019s diverticulum and underwent surgical repair. In total, two of the patients experienced mild non-limiting dyspnea complaints and in four patients the Kommerell\u2019s diverticulum was incidentally documented on a computed tomography (CT) scan acquired for a different indication. The size of the Kommerell\u2019s diverticulum ranged from 19 \u00d7 21 mm to 30 \u00d7 29 mm. In the six patients that did not undergo surgery, a strategy of periodic follow-up with structural imaging was pursued. No significant growth of the Kommerell\u2019s diverticulum was observed and none of the patients experienced an acute aortic syndrome to date. Discussion: Kommerell\u2019s diverticulum in the setting of a right-sided aortic arch with an aberrant left subclavian artery is frequently associated with tracheal and esophageal compression and this may result in a varying range of symptoms. Guidelines on management of Kommerell\u2019s diverticulum are currently lacking. This case series and literature overview suggests that serial follow-up is warranted in adult patients with a Kommerell\u2019s diverticulum with small dimensions and no symptoms, however, that surgical intervention should be considered when patients become symptomatic or when the diameter exceeds 30 mm in the absence of symptoms.<\/jats:p>","DOI":"10.3390\/jcdd8030025","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T06:47:20Z","timestamp":1614322040000},"page":"25","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Clinical Spectrum of Kommerell\u2019s Diverticulum in Adults with a Right-Sided Aortic Arch: A Case Series and Literature Overview"],"prefix":"10.3390","volume":"8","author":[{"given":"Philippe J.","family":"van Rosendael","sequence":"first","affiliation":[{"name":"Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4705-4837","authenticated-orcid":false,"given":"J. Lauran","family":"St\u00f6ger","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippine","family":"Ki\u00e8s","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert W.","family":"Vliegen","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Hazekamp","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Cardiothoracic Surgery, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Koolbergen","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Cardiothoracic Surgery, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildo J.","family":"Lamb","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9132-0418","authenticated-orcid":false,"given":"Monique R. M.","family":"Jongbloed","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, 2333 ZC Leiden, The Netherlands"},{"name":"Department of Anatomy and Embryology, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9312-2338","authenticated-orcid":false,"given":"Anastasia D.","family":"Egorova","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.athoracsur.2015.02.027","article-title":"Evolution in the Management of Aberrant Subclavian Arteries and Related Kommerell Diverticulum","volume":"100","author":"Patel","year":"2015","journal-title":"Ann. 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