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Endobronchial Valve Placement for Persistent Air Leaks Secondary to Pulmonary Infections
Arjan S Flora1, Alejandro Aragaki-Nakahodo1, Sadia Benzaquen2
1Interventional Pulmonology Service, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati Medical Center, Cincinnati, OH.
Journal of Bronchology & Interventional Pulmonology
|May 27, 2020
Summary
Endobronchial valves show promise in treating persistent air leaks from pulmonary infections, with successful chest tube removal in most cases. Further research is needed to confirm their risks and benefits.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Interventional Pulmonology
Background:
- Pneumothoraces from infections have higher treatment failure rates.
- Alveolar-pleural fistulae (APF) from infections are challenging to treat.
- Limited data exists on endobronchial valve use for infectious APF.
Purpose of the Study:
- To evaluate the efficacy of endobronchial valves for APF caused by pulmonary infections.
- To assess the safety and outcomes of this off-label valve application.
Main Methods:
- Retrospective analysis of 19 patients with 22 APF events.
- Off-label use of Olympus Spiration Implantable Endobronchial Valves.
- Single-center study at University of Cincinnati Medical Center.
Main Results:
- Successful chest tube removal in 86.4% of APF events.
- Average time to chest tube removal after valve placement was 12.8 days.
- 30 and 90-day all-cause mortality was 15.8%.
Conclusions:
- Endobronchial valves may be a viable option for select patients with infectious APF.
- Further comparative studies are necessary to establish risks and benefits.
- This approach warrants consideration for persistent air leaks due to infection.
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