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Ann Thorac Surg 1991;51:652-654
© 1991 The Society of Thoracic Surgeons

Articles

Fibrosing mediastinitis with coronary artery involvement

Andrew Cochrane, FRACS*, Roderic Warren, FRACP, Michael Mullerworth, FRACS, Emmanuel Manolas, FRACP

Baker Medical Research Institute and Royal Melbourne Hospital, Melbourne, Australia

Accepted for publication September 5, 1990.

* Address reprint requests to Dr Cochrane, Baker Medical Research Institute, Commercial Rd, Prahran, Victoria, 3181, Australia.

This case report describes a patient with chronic fibrosing mediastinitis involving the entire intrapericardial aorta, innominate artery, and the base of the heart with involvement of the proximal segments of the coronary arteries. This finding was unsuspected before emergency coronary artery bypass grafting. Coronary stenosis due to fibrosing mediastinitis is a rare complication of fibrosing mediastinitis. Owing to the extensive fibrosis, the normal bypass, cardiac preservation, and revascularization techniques required alteration and are discussed.




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