Catheter based treatments for fibrosing mediastinitis

Fender, Erin A.; Widmer, R. Jay; Koepsel, Erica M. Knavel; Welby, John; Kern, Ryan; Peikert, Tobias; Bjarnason, Haraldur; Holmes, David R.

doi:10.1002/ccd.28152

Cited by 29 publications

(30 citation statements)

References 34 publications

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“…Histopathologic studies have indicated B lymphocyte accumulation in fibrosing mediastinitis, and immunotherapy targeting B lymphocytes has demonstrated early, promising results in some patients. 11 This case highlights the value of pathophysiologic understanding, preoperative planning, and the effect of echocardiography on clinical management.…”

Section: Discussionmentioning

confidence: 92%

Pulmonary Artery Stenosis in a Patient with Prior Histoplasmosis and the Discovery of Complications

Songster

Liu

Brakke

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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Pulmonary hypertension (PH) results from varied etiologies, leading to progressive symptoms and limiting physical activity and quality of life, with associated morbidity and mortality. External compression of the pulmonary artery (PA) is a rare cause of PH and may give the clinician cause to investigate compression of nearby structures. In this E-Challenge, the authors present a case of PA stenosis in a patient with prior histoplasmosis scheduled for left PA stenting. However, because the pulmonary veins were not well-visualized on chest computed tomography, the anesthesia team performed a perioperative transesophageal echocardiogram (TEE) to help differentiate the causes of PH. TEE revealed external compression of the pulmonary veins. This case highlights the value of pathophysiologic understanding, preoperative planning, and the effect of echocardiography on clinical management and patient safety. In this case, TEE prevented possible morbidity and mortality.

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Section: Discussionmentioning

confidence: 92%

Pulmonary Artery Stenosis in a Patient with Prior Histoplasmosis and the Discovery of Complications

Songster

Liu

Brakke

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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“…Surgery should be reserved for patients for whom both medical and endovascular treatments have failed. 21…”

Section: Complications Of Endovascular Stentingmentioning

confidence: 99%

A review of endovascular stenting for superior vena cava syndrome in fibrosing mediastinitis

et al. 2019

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Fibrosing mediastinitis (FM) is a rare disorder of inflammation and fibrosis involving the mediastinum. The formation of fibroinflammatory mass in the mediastinum can lead to obstruction of mediastinal structures and cause severe debilitating and life-threatening symptoms. Superior vena cava syndrome (SVCS) is a dreaded complication of FM with no medical therapy proven to be efficacious. Spiral vein grafting has long been utilized as first-line therapy for SVC syndrome due to FM. Endovascular repair with stents and angioplasty for malignant causes of SVC syndrome is well established. However, there are limited data on their utility in SVC syndrome due to FM. We present two cases of SVC syndrome due to FM treated with endovascular stenting and a detailed review of current literature on its utility in SVCS due to benign causes.

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“…It is reported that the average diagnostic age of FM ranges between 20 and 40 years old (1,13,15,16). Histoplasma capsulatum infection is the main cause of FM in North America, but patients of histoplasma capsulatum infection rarely develop FM (1,12).…”

Section: Introductionmentioning

confidence: 99%

“…T h e s y m p t o m s o f F M r e f l e c t t h e m e c h a n i c a l compression of the involved mediastinal structures (16). For example, esophageal compression may cause dysphagia and odynophagia; compression of thoracic duct leads to chylothorax; compressed damage of recurrent laryngeal nerves and phrenic nerve generates the symptoms of hoarseness or shortness of breath.…”

Section: Introductionmentioning

confidence: 99%

Balloon angioplasty or stent implantation for pulmonary vein stenosis caused by fibrosing mediastinitis: a systematic review

Duan

Zhou

et al. 2019

Cardiovasc. Diagn. Ther.

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Fibrosing mediastinitis (FM) is a very rare disease, often caused by histoplasmosis capsulatum, tuberculosis, sarcoidosis, autoimmunity and other diseases, such as IgG 4-related diseases. Fibrous structures in the mediastinum compress the pulmonary artery, pulmonary vein, superior vena cava, esophagus, trachea and cardiac vessels, leading to clinical symptoms. Drug therapeutic modality for pulmonary vein stenosis (PVS) caused by FM is palliative in essence and with limited efficacy, whereas surgical treatment causes high mortality. In recent years, catheter-based treatment to FM-caused PVS has emerged as a promising therapeutic modality, however, the safety and effectiveness of this modality remain unclear. Therefore, a systematic review on the safety and efficacy of the catheter-based treatment for PVS caused by FM was performed, in the hope to shed lights on the alternative therapeutic strategy to this fatal disease.

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Catheter based treatments for fibrosing mediastinitis

Cited by 29 publications

References 34 publications

Pulmonary Artery Stenosis in a Patient with Prior Histoplasmosis and the Discovery of Complications

Pulmonary Artery Stenosis in a Patient with Prior Histoplasmosis and the Discovery of Complications

A review of endovascular stenting for superior vena cava syndrome in fibrosing mediastinitis

Balloon angioplasty or stent implantation for pulmonary vein stenosis caused by fibrosing mediastinitis: a systematic review

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