Delayed targeted atelectasis in a case of bronchoscopic lung volume reduction with endobronchial valves

BMJ Case Rep. 2024 Apr 25;17(4):e256573. doi: 10.1136/bcr-2023-256573.

Abstract

A woman in her late 60s with severe chronic obstructive pulmonary disease (COPD) and emphysema underwent bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBV) to address hyperinflation. The initial EBV placement has led to partial lobar atelectasis of the left lower lobe and resulted in significant improvement in the patient's symptoms and lung function. However, valve migration occurred later due to pneumothorax unrelated to valves, leading to suboptimal clinical improvement. The patient achieved delayed full lobar atelectasis 21 months after EBV placement, which led to a significant clinical improvement. The patient decided to be delisted from the lung transplant list due to the improvement. This case highlights the importance of considering delayed atelectasis as a possible outcome of EBV placement and suggests the need for further exploration of the long-term implications and associations of this procedure.

Keywords: Air leaks; Lung function; Pneumothorax; Respiratory medicine.

Publication types

  • Case Reports

MeSH terms

  • Bronchoscopy* / methods
  • Female
  • Humans
  • Middle Aged
  • Pneumonectomy* / methods
  • Prostheses and Implants
  • Pulmonary Atelectasis* / diagnostic imaging
  • Pulmonary Atelectasis* / etiology
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Pulmonary Disease, Chronic Obstructive* / surgery
  • Pulmonary Emphysema / diagnostic imaging
  • Pulmonary Emphysema / surgery
  • Treatment Outcome