Kommerell's diverticulum with right aortic arch in a shelled heart

Publication date: Available online 4 January 2016 Source:Journal of Indian College of Cardiology Author(s): Shreetal Rajan Nair, Rakesh Jain, C.G. Sajeev, M.N. Krishnan A 36-year-old male presented with dyspnea, abdominal distension, and pedal edema of 6-month duration. He had history of pulmonary tuberculosis. Physical examination showed atrial fibrillation and features of right heart failure. Liver function test was significant for abnormally low serum albumin. Chest X-ray showed nonhomogenous opacity in the right lung with pericardial calcification. Abdominal ultrasonography showed features of cardiac cirrhosis. Transthoracic echocardiogram revealed thickened pericardium, septal bounce, and ventricular interdependency suggestive of constrictive pericarditis. Contrast enhanced computed tomography (CECT) of thorax confirmed constrictive pericarditis. There was an associated finding of right aortic arch and Kommerell's diverticulum of aberrant left subclavian artery on CT which was reconfirmed by invasive angiography. He underwent a successful pericardiectomy. The asymptomatic Kommerell's diverticulum was left alone. The patient is doing well on follow-up. We are reporting the rare combination of right aortic arch with Kommerell's diverticulum.
Source: Journal of Indian College of Cardiology - Category: Cardiology Source Type: research