Pulmonary hypertension due to fibrosing mediastinitis treated successfully with stenting of pulmonary vein stenoses

Can J Cardiol. 2015 Apr;31(4):548.e5-7. doi: 10.1016/j.cjca.2014.12.025. Epub 2014 Dec 24.

Abstract

We describe a patient with fibrosing mediastinitis after childhood histoplasmosis who presented with severe pulmonary hypertension secondary to pulmonary vein stenoses. Stenting of 2 stenosed pulmonary veins via a transseptal approach resulted in an immediate decrease in systolic pulmonary artery pressure from 90 to 68 mm Hg and improvement in dyspnea and cardiac index, which was sustained at 6 months. This case highlights the importance of routinely assessing the pulmonary veins during workup for pulmonary hypertension.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Adult
  • Blood Vessel Prosthesis Implantation / methods*
  • Follow-Up Studies
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / etiology*
  • Hypertension, Pulmonary / surgery
  • Male
  • Mediastinitis / complications*
  • Mediastinitis / diagnosis
  • Pulmonary Veins / surgery*
  • Pulmonary Veno-Occlusive Disease / complications*
  • Pulmonary Veno-Occlusive Disease / diagnosis
  • Pulmonary Veno-Occlusive Disease / surgery
  • Radiography, Thoracic
  • Sclerosis / complications*
  • Sclerosis / diagnosis
  • Stents*
  • Tomography, X-Ray Computed

Supplementary concepts

  • Mediastinal Fibrosis