Bronchial endovalves

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Past history severe emphysema. Attempt to reduce respiratory distress.

Patient Data

Age: 55
Gender: Female
x-ray

Hyperinflated lungs with paucity of lung markings in the upper zones indicative of bullous emphysema. Note metallic stents around the left hilum. They have a particular shape of an expanded distal end with a shorter, narrower section more proximally.

Annotated image

Note metallic stents around the left hilum. They have a particular shape of an expanded distal end with a shorter, narrower section more proximally.

Case Discussion

Endobronchial valves are inserted to reduce the pressure effects of bullae on adjacent more normal lung (in a similar way that surgical excision of large bullae has been undertaken in the past), in order to improve overall lung ventilation in patients with severe emphysema. They are "one-way" valves, i.e. air in the bronchus is prevented from entering the bullae but can escape causing them to deflate. This is effectively a bronchoscopic technique of lung volume reduction.

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