Kommerell’s Diverticulum with aberrant right subclavian artery

I found out that I have a right sided aortic arch with a abberent left subclavian artery with a kommerell diverticulum and is having coughing shortness of breath when exercising and coughing after eating a big meal I also have a positive Ana titer hypertension and I have noticed a difference in my Bp readings in my arms like my left arm will read 146/90 and my right would read 120/90

I found out that I have a right sided aortic arch with a abberent left subclavian artery with a kommerell diverticulum and is having coughing shortness of breath when exercising and coughing after eating a big meal I also have a positive Ana titer hypertension and I have noticed a difference in my Bp readings in my arms like my left arm will read 146/90 and my right would read 120/90

Hi @abutler27 and welcome to Mayo Clinic Connect. Are you looking to connect with others who have the same thing or looking to get questions answered?

I’m trying to get some questions answered and also figure out how do I go about getting an appointment

I’m trying to get some questions answered and also figure out how do I go about getting an appointment

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 Jackie!
I live on Vancouver Island and was diagnosed with KD/ARSA over 2yrs ago. I have been through a variety of tests and would really just like to be fixed. I had a surgeon here in Victoria but had a second opinion consultation with a doctor in Vancouver who wanted me to get surgery asap. After talking to his "team" they want MORE testing. I am a single mom of 2, age 40 and I will just like to be able to eat/sleep/breath properly. If you have any insight....I would love to connect!!!! My aneurysm is 25mm!!!! If I had the money I would have been at a Mayo clinic 2yrs ago and ready to get my life back to normal.
Thanks!
Abbie

@jbell22 thank you for answering! I am so sorry to hear about all of your issues first of all. I have known since childhood I had a bicuspid aortic valve, in the past 6 mos. I have had a spike in my diastolic pressures, my cardiologist started me on meds but my echo really didn’t look that bad so he just wanted to make sure there was nothing else causing the pressure other than the stenosis from the valve- so I had a cardiac MRI. I live in Pensacola, which is one of the smaller cities in Florida, my cardiologist and the surgeons here saw the scan and never seen this before, so really they couldn’t or wouldn’t speculate treatment or even really confirm diagnosis yet, in fact I have heard many different measurements of my KD from them so I am not even sure how big it is! Our hospital here has a affiliation with Mayo, so we reached out immediately. It’s only been a month since we did that so we are still working with coordinators to schedule a visit, I have found it’s not quick process. My husband is a physician, so we have tried to find some answers through his colleagues as well, but honestly I have not heard really anything from any physician other than I need to go to Mayo. My MRI result reads left aortic arch with right aberrant subclavian with KD of 3.5cm, but like I said the docs here aren’t agreeing in measurements, most have never read a scan with this before either. I have no symptoms- so I feel very fortunate. It sounds like your issue is very complicated and painful. I will just be glad to sit down with a dr who can confidently tell me what is going on and answer my questions- the unknowns are starting to cause a little anxiety. I am really apprehensive surgery. Did you have all of your procedures and surgeries at Mayo? How has your experiences there been? The coordinator has been working for over a month and I still do not have an appointment, but I also feel like I am not an emergent case so I am trying to be patient . Thank you for discussing this with me!!!

Hi!! So sorry to hear you had to go through all of this. I had aberrant right subclavian. I had surgery Nov 2019 at Mayo Rochester with Dr. Bower. My case is unique in the sense- i had no symptoms whatsoever. I also had no dilatation of the aberrant artery. I did have a large left subclavian aneurysm and descending aortic aneurysm. My cardiologist here in Florida sent me to Mayo right away, and with Dr. Bower and Dr. Pochettino help I had a 2 day surgery-- day one Dr. Bower relocated my aberrant artery to my carotid( only because it was in the way for my aortic grafts I needed) and day 2 Dr. Pochettino replaced a large portion of my aorta and left subclavian. I highly recommend if you are needing a second opinion trying Mayo. Not many doctors know how to approach an aberrant artery. If your not having symptoms it may just require some routine imaging--mine was a Ct scan. I was told the main issue with this is the development of Kommeralls diverticulum-- which is basically an aneurysm on the right subclavian-which doesn't happen all the time. Dr. Bower told me that if I did not need the aberrant artery moved because it was in the way of the graft for my other issues- he doubts my aberrant artery would have ever caused me any issues. I highly recommend before you panic to see a dr who is well experienced with this issue like Dr. Bower. It really did help me. Best wishes.

Jeane