Fibrosing mediastinitis with severe bilateral pulmonary artery narrowing: RV-RPA bypass with a homograft conduit.
Although fibrosing mediastinitis is uncommon, it is a devastating sequela of certain granulomatous diseases. The compression of mediastinal structures can lead to severe cardiopulmonary symptoms. We report the case of a 50-year-old woman who presented with severe bilateral branch pulmonary artery compression 6 months after bilateral pulmonary artery stenting. We performed bypass surgery with use of a homograft conduit. Seven months postoperatively, the homograft and stent in the right pulmonary artery were patent, and the patient had resumed activities of daily living, including full-time employment. In addition to reporting this patient's case, we discuss surgery as an alternative to stenting in patients with fibrosing mediastinitis.
Division of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, Arizona 85724, USA.
Monica R
MR
Gustafson
Michael J
MJ
Moulton
D000800:Angioplasty, Balloon / Q000295:instrumentation; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D003251:Constriction, Pathologic; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008480:Mediastinitis / Q000150:complications*; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D011664:Pulmonary Valve / Q000637:transplantation; D011859:Radiography; D012598:Sclerosis / Q000150:complications*; D012720:Severity of Illness Index; D015607:Stents; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014654:Vascular Patency