1103: BRONCHOPLEURAL FISTULA WITH PERSISTENT AIR LEAK NECESSITATING ENDOBRONCHIAL VALVE PLACEMENT

Bronchopleural fistula (BPF) is associated with high morbidity if left untreated. Although rare, the frequency of BPF in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is becoming recognized in medical literature. We present a case of a 64-year-old male with BPF with persistent air leak due to SARS-CoV-2 pneumonia treated with Spiration Valve System endobronchial valve (EBV). An EBV was placed in the right middle lobe with successful cessation of air leak. In conclusion, the use of EBVs for BPF with persistent air leaks in SARS-CoV-2 patients who are poor surgical candidates is effective and safe.

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Case report: Endobronchial valve placement for treatment of a persistent air leak

Breathe ◽

10.1183/20734735.013115 ◽

2016 ◽

Vol 12 (1) ◽

pp. 61-64 ◽

Cited By ~ 3

Author(s):

Morvern Morrison ◽

Adam Marshall ◽

Santiago Giavedonni ◽

Malcolm Will ◽

Tom MacKay ◽

...

Keyword(s):

Case Report ◽

Air Leak ◽

Endobronchial Valve ◽

Valve Placement ◽

Persistent Air Leak

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Bronchopleural Fistula Resolution with Endobronchial Valve Placement and Liberation from Mechanical Ventilation in Acute Respiratory Distress Syndrome: A Case Series

Case Reports in Critical Care ◽

10.1155/2017/3092457 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Haris Kalatoudis ◽

Meena Nikhil ◽

Fuad Zeid ◽

Yousef Shweihat

Keyword(s):

Mechanical Ventilation ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Failure ◽

Respiratory Distress Syndrome ◽

Distress Syndrome ◽

Severe Respiratory Failure ◽

Air Leak ◽

Endobronchial Valve ◽

Valve Placement ◽

Persistent Air Leak

Patients who have acute respiratory distress syndrome (ARDS) with persistent air leaks have worse outcomes. Endobronchial valves (EBV) are frequently deployed after pulmonary resection in noncritically ill patients to reduce and eliminate bronchopleural fistulas (BPFs) with persistent air leak (PAL). Information regarding EBV placement in mechanically ventilated patients with ARDS and high volume persistent air leaks is rare and limited to case reports. We describe three cases where EBV placement facilitated endotracheal extubation in patients with severe respiratory failure on prolonged mechanical ventilation with BPFs. In each case, EBV placement led to immediate resolution of PAL. We believe endobronchial valve placement is a safe method treating persistent air leak with severe respiratory failure and may reduce days on mechanical ventilation.

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Endobronchial Valve Placement and Balloon Occlusion for Persistent Air Leak

CHEST Journal ◽

10.1378/chest.12-2746 ◽

2013 ◽

Vol 144 (2) ◽

pp. 661-665 ◽

Cited By ~ 13

Author(s):

Kevin L. Kovitz ◽

Kim D. French

Keyword(s):

Balloon Occlusion ◽

Air Leak ◽

Endobronchial Valve ◽

Valve Placement ◽

Persistent Air Leak

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Endobronchial valve placement as a treatment of persistent pulmonary air leak

10.1183/13993003.congress-2016.pa760 ◽

2016 ◽

Author(s):

Laura Rodriguez Pons ◽

Agnes Hernández Biette ◽

José Sanz Santos ◽

Enrique Cases Viedma ◽

Felipe Andreo Garcia ◽

...

Keyword(s):

Air Leak ◽

Endobronchial Valve ◽

Valve Placement

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Endobronchial valves for bronchopleural fistula: pitfalls and principles

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753465816672132 ◽

2016 ◽

Vol 11 (1) ◽

pp. 3-8 ◽

Cited By ~ 6

Author(s):

Dany Gaspard ◽

Thaddeus Bartter ◽

Ziad Boujaoude ◽

Haroon Raja ◽

Rohan Arya ◽

...

Keyword(s):

Success Rate ◽

Bronchopleural Fistula ◽

Apparent Lack ◽

Endobronchial Valve ◽

Valve Placement ◽

Guiding Principles ◽

Difficult Cases

Background: Placement of endobronchial valves for bronchopleural fistula (BPF) is not always straightforward. A simple guide to the steps for an uncomplicated procedure does not encompass pitfalls that need to be understood and overcome to maximize the efficacy of this modality. Objectives: The objective of this study was to discuss examples of difficult cases for which the placement of endobronchial valves was not straightforward and required alterations in the usual basic steps. Subsequently, we aimed to provide guiding principles for a successful procedure. Methods: Six illustrative cases were selected to demonstrate issues that can arise during endobronchial valve placement. Results: In each case, a real or apparent lack of decrease in airflow through a BPF was diagnosed and addressed. We have used the selected problem cases to illustrate principles, with the goal of helping to increase the success rate for endobronchial valve placement in the treatment of BPF. Conclusions: This series demonstrates issues that complicate effective placement of endobronchial valves for BPF. These issues form the basis for troubleshooting steps that complement the basic procedural steps.

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Endobronchial valve placement for the treatment of bronchopleural fistula

Current Opinion in Pulmonary Medicine ◽

10.1097/mcp.0000000000000063 ◽

2014 ◽

Vol 20 (4) ◽

pp. 347-351 ◽

Cited By ~ 19

Author(s):

Olivia Giddings ◽

Judit Kuhn ◽

Jason Akulian

Keyword(s):

Bronchopleural Fistula ◽

Endobronchial Valve ◽

Valve Placement

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Endobronchial Valve Management of a Persistent Air Leak Complicating Bullous Emphysema

CHEST Journal ◽

10.1378/chest.1388754 ◽

2012 ◽

Vol 142 (4) ◽

pp. 897A

Author(s):

Philip Svigals ◽

Luca Paoletti ◽

Nicholas Pastis ◽

John Huggins

Keyword(s):

Air Leak ◽

Endobronchial Valve ◽

Persistent Air Leak

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Successful use of endobronchial valve for persistent air leak in a patient with COVID-19 and bullous emphysema

BMJ Case Reports ◽

10.1136/bcr-2021-246671 ◽

2021 ◽

Vol 14 (11) ◽

pp. e246671

Author(s):

Biplab K Saha ◽

Alyssa Bonnier ◽

Woon Hean Chong ◽

Praveen Chenna

Keyword(s):

Chest Pain ◽

Lung Disease ◽

Chest Tube ◽

Complete Resolution ◽

Shortness Of Breath ◽

Air Leak ◽

Management Guideline ◽

Standard Management ◽

Endobronchial Valve ◽

Persistent Air Leak

Patients with SARS-CoV-2 pneumonia can suffer from pneumothorax and persistent air leak (PAL). The pneumothorax occurs with or without pre-existing lung disease. PAL refers to air leak lasting more than 5–7 days and arises due to bronchopleural or alveolopleural fistula. The management of PAL can be challenging as a standard management guideline is lacking. Here we present the case of a 42-year-old smoker with COVID-19 who presented to the hospital with fever, cough, acute left-sided chest pain and shortness of breath. He suffered from a large left-sided pneumothorax requiring immediate chest tube drainage. Unfortunately, the air leak persisted for 13 days before one-way endobronchial valve (EBV) was used with complete resolution of the air leak. We also review the literature regarding other cases of EBV utilisation for PAL in patients with COVID-19.

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Utility of Endobronchial Valves in a Patient with Bronchopleural Fistula in the Setting of COVID-19 Infection: A Case Report and Brief Review

Southwest Journal of Pulmonary and Critical Care ◽

10.13175/swjpcc046-21 ◽

2021 ◽

Vol 23 (4) ◽

pp. 109-114

Author(s):

Nazanin Sheikhan ◽

◽

Elizabeth Benge ◽

Amanpreet Kaur ◽

Jerome Hruska ◽

...

Keyword(s):

Mechanical Ventilation ◽

Acute Respiratory Distress Syndrome ◽

Case Report ◽

Distress Syndrome ◽

Bronchopleural Fistula ◽

Invasive Mechanical Ventilation ◽

Air Leak ◽

Mechanically Ventilated ◽

Growing Body ◽

Endobronchial Valve

Patients with COVID-19 pneumonia frequently develop acute respiratory distress syndrome (ARDS), and in severe cases, require invasive mechanical ventilation. One complication that can develop in patients with ARDS who are mechanically ventilated is a bronchopleural fistula (BPF). Although rare, the frequency of BPF in patients with COVID-19 pneumonia is increasingly recognized. Here, we present a 48-year old man with BPF associated with COVID-19 pneumonia. Treatment with a commercial endobronchial valve (EBV) system resulted in reduced air leak allowing for tracheostomy placement. Our case adds to a growing body of evidence suggesting that the presence of COVID-19 pneumonia does not hinder the utility of EBV’s in the treatment of BPF’s.

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