Fibrosing mediastinitis with severe bilateral pulmonary artery narrowing: RV-RPA bypass with a homograft conduit.

Although fibrosing mediastinitis is uncommon, it is a devastating sequela of certain granulomatous diseases. The compression of mediastinal structures can lead to severe cardiopulmonary symptoms. We report the case of a 50-year-old woman who presented with severe bilateral branch pulmonary artery compression 6 months after bilateral pulmonary artery stenting. We performed bypass surgery with use of a homograft conduit. Seven months postoperatively, the homograft and stent in the right pulmonary artery were patent, and the patient had resumed activities of daily living, including full-time employment. In addition to reporting this patient's case, we discuss surgery as an alternative to stenting in patients with fibrosing mediastinitis.