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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.


   Abstract
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 Abstract
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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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  1. Schowengerdt CG, Suyemoto R, Main FB. Granulomatous and fibrous mediastinitis—a review and analysis of 180 cases J Thorac Cardiovasc Surg 1969;57:365-379.[Medline]
  2. Hicks GL. Fibrosing mediastinitis complicating coronary artery surgery—use of the descending thoracic aorta J Cardiovasc Surg 1985;26:514-515.[Medline]
  3. Berry DF, Buccigrossi BS, Peabody J, et al. Pulmonary vascular occlusion and fibrosing mediastinitis Chest 1986;89:296-301.[Medline]
  4. Akins CW, Carroll DL. Event-free survival following nonemergency myocardial revascularization during hypothermic fibrillatory arrest Ann Thorac Surg 1987;43:628-633.[Abstract/Free Full Text]
  5. Ott DA, Cooley DA. The difficult proximal coronary anastomosis Cardiovasc Dis Bull Tex Heart Inst 1979;6:55.
  6. Robicsek F, Rubenstein R. Calcification and thickening of the aortic wall complicating aortocoronary grafting: a technical modification Ann Thorac Surg 1980;29:84-85.[Abstract/Free Full Text]
  7. Weinstein G, Killen DA. Innominate artery-coronary artery bypass graft in a patient with calcific aortitis J Thorac Cardiovasc Surg 1980;79:312-313.[Abstract]
  8. Holland DL, Hieb RE. Revascularization without embolization: coronary bypass in the presence of a calcific aorta Ann Thorac Surg 1985;40:308-310.[Abstract/Free Full Text]



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This Article
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