The use of endobronchial valve device to eliminate air leak.
We evaluated an endobronchial valve device in the treatment of surgically created air leak or pneumothorax by eliminating antegrade flow.


METHODS
Six sheep underwent general anesthesia with positive pressure ventilation and left thoracotomy. After division of the mediastinal pleura, the contralateral cranial lobe was identified and a 2.5 cmx1.5 cm laceration created with resultant air leak. Using bronchoscopy, we deployed a valve device in the bronchus of the injured segment. Chest drainage tube was placed and the thoracotomy closed. At 1 week (n=3) and 4 weeks (n=3), the animals underwent general anesthesia, bronchoscopy and right thoracotomy.


RESULTS
All animals survived the procedure. Bronchoscopic valve device placement in the segmental bronchus resolved the air leak immediately. After closure of thoracotomy, the chest tube demonstrated minimal drainage with no air leak. At 1 and 4 weeks, bronchoscopy showed no change in device location, and the treated segments were atelectatic with fibrous scar at the injured site.


CONCLUSIONS
Collapse of a selected lung segment with resolution of air leak can be achieved using bronchoscopically implanted valve device. The valve device may facilitate treatment of patients with post-surgical or post-traumatic persistent air leak.
Fann
James I
JI
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford 94305, and The Section of Cardiothoracic Surgery, Palo Alto Veterans Affairs HCS, Palo Alto, CA, USA. jfann@stanford.edu
Berry
Gerald J
GJ
Burdon
Thomas A
TA
D000818:Animals; D001983:Bronchial Fistula / Q000601:surgery*; D001999:Bronchoscopy; D011030:Pneumothorax / Q000601:surgery*; D019736:Prostheses and Implants; D012756:Sheep; D016896:Treatment Outcome