The impact of Kommerell diverticulum resection on patient outcomes: A 21-year comparative analysis of surgical techniques for vascular rings.

Objective: Kommerell diverticulum is an embryologic remnant of the dorsal fourth aortic arch. It often presents as part of vascular rings with a right dominant arch. Historically, these have been treated by dividing the ligamentum arteriosum. In recent years, some centers have adopted Kommerell diverticulum resection with subclavian translocation as a primary approach. However, no long-term studies have directly compared outcomes with simple ligamentum division. To address this, we conducted a 21-year dual-institution review comparing short- and long-term outcomes across surgical strategies. Methods: A retrospective review of 131 patients who underwent vascular ring repair at 2 institutions was performed. Of these, 93 underwent simple ligamentum division and 38 underwent Kommerell diverticulum resection with subclavian artery translocation. Anatomic subtypes, symptoms, perioperative outcomes, and follow-up data were compared. Results: There were no significant differences in intraoperative or postoperative complication rates between groups. Short-term symptoms such as dyspnea ( Conclusions: Kommerell diverticulum resection with arterial translocation is safe and effective, with favorable outcomes comparable to simple ligamentum division.