Pulmonary Procedures |

Endobronchial Valve Treatment for Prolonged Pulmonary Air Leaks FREE TO VIEW

Danai Khemasuwan, MD; Michael Simoff, MD; Cyndi Ray, MD; Javier Diaz-Mendoza, MD
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Henry Ford Hospital, Detroit, MI

Chest. 2015;148(4_MeetingAbstracts):825A. doi:10.1378/chest.2250723
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SESSION TITLE: Interventional Pulmonology Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: A prolonged pulmonary air leak is usually managed conservatively in patients who are not surgical candidates. It is associated with a prolonged length of stay and increased morbidity. The use of endobronchial valve (EBV) is considered as an effective salvage procedure in this setting.

METHODS: This is a retrospective study of patients with prolonged air leaks, treated with EBV placement after balloon occlusion test via flexible bronchoscopy. EBV placement was guided by balloon occlusion, and response seen on mechanical ventilator and pleurovac. Clinical characteristic, underlying lung disease and outcomes were analyzed.

RESULTS: From September 2011 to December 2014, sixteen patients (mean age of 65.5 years), were treated with EBV placement. Fourteen patients (88%) had cessation of the air leaks which led to removal of chest tubes. Four patients underwent a second procedure. Averages of 4.3 valves were placed in this study group. Time from EBV placement to chest tube removal ranged from 2 to 25 days (median 6 days). Seven patients (50%) had loculated pneumothorax from chest imaging (CXR and/or CT chest) at the time of chest tube removal. Elective removal of EBV was at a median of 58 days after placement. There was no complication related to procedure or valve placement in this cohort.

CONCLUSIONS: A placement of EBV is safe, minimally invasive bronchoscopic intervention for patients with prolonged pulmonary air leaks. Measurement of air leak by mechanical ventilation can be used to guide EBV placement.

CLINICAL IMPLICATIONS: A placement of endobronchial valve can be considered as an alternative to surgery in patients with prolonged pulmonary air leaks.

DISCLOSURE: The following authors have nothing to disclose: Danai Khemasuwan, Michael Simoff, Cyndi Ray, Javier Diaz-Mendoza

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