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Development of a Giant Bulla After Lung Volume Reduction Surgery*

Mobeen Iqbal, MD; Leonard Rossoff, MD; Kerry Mckeon, RN, RRT; Michael Graver, MD, FCCP; Steven M. Scharf, MD, PhD
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*From the Division of Pulmonary and Critical Care Medicine (Drs. Iqbal, Rossofl, McKeon, and Scharf) and the Division of Cardiothoracic Surgery (Dr. Graver), Long Island Jewish Medical Center, New Hyde Park, NY 11040.

Correspondence to: Leonard Rossoff, MD, Department of Pulmonary and Critical Care, Room C-20, Long Island Jewish Medical Center, New Hyde Park, NY 11040



Chest. 1999;116(6):1809-1811. doi:10.1378/chest.116.6.1809
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Lung volume reduction surgery (LVRS) is being evaluated in the treatment of emphysema. The proposed mechanisms of improvement are increased elastic recoil of the lung and improved mechanical efficiency of the muscles of respiration. We report a unique patient with emphysema who developed a giant bulla 3 years subsequent to LVRS. The patient underwent extensive evaluation, including measurements of lung mechanics. Bullectomy was performed, but it was unsuccessful. Although the mechanisms behind the development of giant bullous disease remain speculative, heterogeneous improvement in elastic recoil following LVRS may be one of the responsible mechanisms.

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