Conflict of interest: Nothing to report.
Valvular and Structural Heart Diseases
A pressing matter—mediastinal fibrosis with near obliteration of the pulmonary arteries
Article first published online: 14 NOV 2012
Copyright © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 81, Issue 6, pages 1079–1083, May 2013
How to Cite
Murphy, J. C., Johnston, N. and Spence, M. S. (2013), A pressing matter—mediastinal fibrosis with near obliteration of the pulmonary arteries. Cathet. Cardiovasc. Intervent., 81: 1079–1083. doi: 10.1002/ccd.24561
- Issue published online: 19 APR 2013
- Article first published online: 14 NOV 2012
- Accepted manuscript online: 19 JUL 2012 05:42AM EST
- Manuscript Accepted: 6 JUL 2012
- Manuscript Received: 1 JUN 2011
- pulmonary angiography;
- right ventricle;
- mediastinal fibrosis
Idiopathic mediastinal fibrosis is a rare, histologically benign condition which often presents with symptoms attributable to compression of vital mediastinal structures. Diagnosis can be difficult and individualized treatments are required for patients, with possible intervention including pharmacotherapy, surgery, and percutaneous stenting. We present a case of idiopathic mediastinal fibrosis present in a 50-year-old woman as compression and near obliteration of the pulmonary arteries. A percutaneous approach was utilized with bilateral balloon expandable kissing stents simultaneous deployed from the main pulmonary artery to the right and left pulmonary arteries. There was instantaneous improvement in the pulmonary and systemic hemodynamics. Her immediate postprocedure course was complicated by reperfusion injury to the right lung, requiring intubation and ventilation. The patient made a full recovery and remains well at 6 months. Our case highlights the procedural and postprocedural difficulties that exist in such cases, and reinforces the value of endovascular stenting strategies in the management of patients with this rare condition. © 2012 Wiley Periodicals, Inc.