Kommerell’s Diverticulum with aberrant right subclavian artery

It is all very confusing isn't it. Oddly, I was diagnosed with a bicuspid aortic valve when I was about 12. Thought I had it my whole life but when my congenital defect arose, testing eventually showed I didn't have that. I live in Courtenay BC on Vancouver Island and have to go to Vancouver for all my testing (takes about 6 hours one way - 2 hour ferry trip included in that). I would love to have the option of the Mayo Clinic but would need to win the lottery, haha. Surgery is scary but you are going to the best place and they really know what they are doing. 😊

I’m curious on what you were told when you went to Mayo Clinic? I was found to have a right aortic arch with an aberrant left subclavian artery and Diverticulum of Kommerell on an MRI due to my cardiologist hearing a Brue. I’m 35. My cardiologist wasn’t concerned at all and said he‘all scan me again in a year but I’m still concerned. I don’t know the size or anything. It’s hard to find much research or see what the standard of treatment is.

I am absolutely shocked reading your post - I have exactly the same thing. There should be a post on here from a few years ago describing my situation. I did not know there was anything wrong with me until I was into my 50's (I am 59 now). I have had one very complex surgery in which they went through my back because my aberrant left subclavian artery had eroded my spinal column and embedded in there. There is a second frontal surgery being discussed because of the Kommerellis diverticulum and a vascular ring crushing my esophagus and trachea. I have had conflicting opinions on the danger of the KD erupting. The discovery of my heart issues came when I got very sick, perhaps because you are not, you may never need surgery. I hope that is the case for you.

Thank you for your reply. May I ask where you are being treated? I hope everything goes well with your second surgery if needed. My physician said it’s very rare for it to rupture but then told me to keep something on me with the diagnosis just in case. He said otherwise just live life normally. I have 2 little ones and the idea of it rupturing terrifies me. It’s just so hard to find info on it and I’m not sure how familiar my cardiologist is with it. When giving me the results of my MRI he didn’t even mention it by name but I asked about it because I had already read the MRI report on my my chart Before seeing him. Then after I asked about it is when he said we would scan again in a year. If I wouldn’t have brought it up we wouldn’t do anything. I feel like from what o have read it doesn’t seem like it’s a problem until later years of life but I kind of feel like a ticking time bomb. It’s very unsettling.

It is very unsettling and difficult to not think about. I live in B.C. and my surgery was at St. Paul's Hospital in Vancouver, B.C. - I live on Vancouver Island. Sadly, the Mayo Clinic is not an option for me unless I win a lottery. There is a 2016 study out of Virginia that says KD's should 'be called Kommerellis Aneurysm and not Kommerellis Diverticulum because of their unpredictability and catastrophic nature' and it goes on to explain why. My surgeon called it an aneurysm but my cardiologist now feels as your does that it shouldn't be under the aneurysm umbrella, that they are unlikely to rupture or rare to rupture but considering what we have is very rare, it seems par for the course. I hope this isn't too much negative stuff and I apologize if so.

Hi, not sure if this is still active. I am going to see a specialist for unrelated issues and was going through old reports/data. I am 37 year old male and 10 years ago, doctor thought I had cancer and wanted to see if it spread so did a chest CT scan. It turned out to be false alarm and he was wrong and there was no cancer anywhere. I just looked at the report and actually read it where it mentions incidental finding of aberrant right subclavian artery stemming from diverculosis kommerell. The doctor never brought this up to me 10 years ago. I am in the process of setting up appointment with a vascular surgeon and would imagine I need current imaging. Have any of you have this? Is this something that you just live with and it's not an issue? What sort of lab work/imagining did you have on this? Did you put in stents? Any info on this would be much appreciated! There is really not much on the web about this.

Thank you!

Hi @akeyfes, welcome to Mayo Clinic Connect. How disheartening to know that something was found on your imaging, but not addressed.
I know that members like @jbell22 and @ggopher who not only posted here, but also in another discussion regarding kommerell diverticulum.
https://connect.mayoclinic.org/discussion/right-facing-aorta-with-kommerellis-diverticulum/
You may be interesting in this NIH article as well:
- Kommerell's diverticulum: A rare aortic arch anomaly https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192231/

Have you been asymptomatic or have you had any swallowing or breathing issues?

Asymptomatic. In fact as of last week I was doing an hour of hardcore cycling and heavy weightlifting 6 days a week. I am just in horror that I may have been literally risking my life with each rep. It is beyond frustrating that is wasn't addressed when it came up and I was young (in my 20s).

The idea I may just drop dead randomly is really, really scaring the living day lights out of me...

I bet! I can't imagine that weighing on your conscience every day. They do have different approaches for symptomatic versus asymptomatic patients.

Hybrid endovascular treatment for an asymptomatic Kommerell diverticulum at the right aortic arch - https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2816%2900263-9

This one is lengthy, but it is a Mayo Clinic Proceeding
https://www.mayoclinicproceedings.org/action/showPdf?pii=S0025-6196%2812%2960196-7
Were you able to make an appointment with the vascular surgeon to get a second opinion?