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Obstructive Lung Diseases |

Quantitative CT Assessment of Bronchoscopic Lung Volume Reduction With Valve FREE TO VIEW

Huang Junfang, MD; Wang Rui, MD; Qiu Jianxin, MD; Zhang Hong, MD; Guangfa Wang, MD
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Peking University 1st Hospital, Beijing, China


Chest. 2014;145(3_MeetingAbstracts):361A. doi:10.1378/chest.1836319
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Abstract

SESSION TITLE: COPD Epidemiology & Physiology Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: to evaluate quantitative CT analysis on the follow up of COPD patients who accepting valve lung volume reduction and try to explore its mechanism on the effect on COPD lung

METHODS: 4 COPD patients, accepting valve volume reduction procedure during Sep.1st ,2011 and Dec 31st, 2012, were enrolled into the study. A retrospective analysis of lung function, 6MWD, Borg scale and CT quantitative parameters before and after the procedure was performed. The volume and %LAV-950,as well as Ai, WA% and TDR of bilateral B1, B4 and B10. in each lobe were compared using ADW 4.2 software,

RESULTS: There were four patients included at last. Operative sides were 2 for right upper lobe, 1 for right middle lobe and 1 for left lower lobe. After the procedure, 2(0.5-7)[55 (25-77.78)%, P=0.147] points of best Borg scale decrease was observe. The best 6MWD improvement was 175.25 (55-290) meters[153.9(23.91-241)%, P=0.05]. The best improvement of FEV1 was 0.22(0.12-0.47)L[48.41(20.34-70.15)%, p=0.057] , while FVC was 0.74(0.36-0.75)L[42.63(18.65-48.04)%, P=0.012)]. The largest reduction was 0.92(0.65-1.12)L for RV[12.92(8.84-15.62)%, P=0.003] and 0.37(-0.13-0.47)L for TLC[3.92(-1.57-4.5)%, P=0.142]. RV%TLC was reduced by 7.5(5.83-11.53)%[9.78(7.1-15.95)%, P=0.009].For quantitative CT analysis, there were 7 ipsilateral and 8 contralateral lobes in total. And there were 8 ipsilateral and 12 contralateral bronchi for measurement. 3 cases acquired volume reduction of whole lung and targeted lobes. Of 7 non-targeted lobes at the same side, 6 were observed with volume expanding(P=0.041). The volume of 4 lobes was decreased among 9 contralateral lobes. %LAV-950 was reduced in all target lobs, 6 of 7 ipsilateral lobes and 5 of 9 contralateral lobes. Ai enlargement and WA% attenuation were observed in 5 of 8 ipsilateral bronchi (P=0.164 for Ai, P=0.547 for WA%) and 9 of 12 contralateral bronchi (P=0.016 for Ai, P=0.051 for WA%)

CONCLUSIONS: The 4 COPD patients accepted bronchscopic valve volume reduction got significant improvement physiologically. Quantitative CT analysis revealed that valve volume reduction not only reduce the volume of the target lobes but also have beneficial effects on homo- and contra-lateral lobes. It can increase the volume of non-target lobes, dilate non target bronchi and alleviate air trapping.

CLINICAL IMPLICATIONS: Lung volume reduction surgery with valve can improve the lung function, quality of life by increase the volume of non-target lobes, dilate non target bronchi and alleviate air trapping.

DISCLOSURE: The following authors have nothing to disclose: Huang Junfang, Wang Rui, Qiu Jianxin, Zhang Hong, Guangfa Wang

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