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Westhoff M, Hardebusch T, Litterst P, Breithecker A, Haas M, Kuniss M, Neumann T, Guth S, Wiedenroth CB. Successful simultaneous stenting of a pulmonary artery and vein in pulmonary vascular stenosis due to silicosis. Case report and literature review. Front Cardiovasc Med 2023; 10:1108768. [PMID: 37229232 PMCID: PMC10203551 DOI: 10.3389/fcvm.2023.1108768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/16/2023] [Indexed: 05/27/2023] Open
Abstract
A 58-year-old patient was admitted to the emergency department due to severe respiratory insufficiency. Anamnesis revealed that the patient had experienced increasing stress dyspnea for a few months. Upon imaging, an acute pulmonary embolism was excluded, but peribronchial and hilar soft tissue proliferation with compression of central parts of the pulmonary circulation was found. The patient had a history of silicosis. The histology report showed tumor-free lymph node particles with prominent anthracotic pigment and dust depositions without evidence of IgG4-associated disease. The patient was administered steroid therapy and underwent simultaneous stenting of the left interlobular pulmonary artery and the upper right pulmonary vein. As a result, a significant improvement in symptoms and physical performance was achieved. The diagnosis of inflammatory or, in particular, fibrosing mediastinal processes can be challenging and important clinical symptoms must be taken into account, especially if the pulmonary vasculature is involved. In such cases, the possibility of interventional procedures should be examined in addition to drug therapy options.
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Affiliation(s)
- M. Westhoff
- Department of Pulmonology, Klinik für Pneumologie, Schlaf und Beatmungsmedizin, Lungenklinik Hemer, Zentrum für Pneumologie und Thoraxchirurgie, Hemer, Germany
- Universität Witten/Herdecke University, Witten, Germany
| | - T. Hardebusch
- Department of Pulmonology, Klinik für Pneumologie, Schlaf und Beatmungsmedizin, Lungenklinik Hemer, Zentrum für Pneumologie und Thoraxchirurgie, Hemer, Germany
| | - P. Litterst
- Department of Pulmonology, Klinik für Pneumologie, Schlaf und Beatmungsmedizin, Lungenklinik Hemer, Zentrum für Pneumologie und Thoraxchirurgie, Hemer, Germany
| | - A. Breithecker
- Department of Radiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - M. Haas
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - M. Kuniss
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - T. Neumann
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - S. Guth
- Department of Thoracic Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - C. B. Wiedenroth
- Department of Thoracic Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
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Furtado AD, Shivanna DN, Rao SPK, Bhat S, Suresh S, Peer SM. Pulmonary artery bypass for in-stent stenosis following angioplasty for isolated pulmonary Takayasu arteritis. J Card Surg 2012; 27:365-7. [PMID: 22497309 DOI: 10.1111/j.1540-8191.2012.01440.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pulmonary artery (PA) stenosis due to Takayasu Arteritis (TA) is usually managed by angioplasty techniques. We present a patient with isolated PA stenosis with TA with in-stent stenosis. The surgical management and pathophysiology of this disease are reviewed.
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Affiliation(s)
- Arul Dominic Furtado
- Department of Cardio-Thoracic Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
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