title: Endobronchial valve placement and balloon occlusion for persistent air leak: procedure overview and new current procedural terminology codes for 2013.
abstract: Unidirectional endobronchial valves, originally studied for potential treatment of emphysema, have emerged as a useful intervention for patients with persistent air leak from the lung. The procedure is accomplished via bronchoscopy in a patient who already has a chest tube in place for management of the air leak. It uses an occluding balloon to determine the specific airway(s) leading to the leak by impact on airflow and subsequent placement of removable valve(s) in one or more segment or subsegments to decrease flow across the leak to allow for healing of the fistula. Specific US Food and Drug Administration-approved criteria for placement and removal of these valves via a Humanitarian Device Exemption are discussed along with reported outcomes. Current Procedural Terminology codes effective for 2013 that are specific to the procedure are reviewed.
authors.affiliation: Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Hospital & Health Sciences System, Chicago; Chicago Chest Center, Elk Grove Village, IL. Electronic address: kkovitz@uic.edu.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kovitz
authors.affiliation: Suburban Lung Associates, Elk Grove Village, IL.
authors.forename: Kim D
authors.initials: KD
authors.lastname: French
mesh_terms: D021721:Balloon Occlusion; D001983:Bronchial Fistula / Q000628:therapy*; D001999:Bronchoscopy; D015505:Chest Tubes; D039702:Current Procedural Terminology; D018795:Device Approval; D006801:Humans; D011030:Pneumothorax / Q000628:therapy*; D011183:Postoperative Complications / Q000628:therapy*; D019919:Prosthesis Implantation / Q000379:methods*; D011656:Pulmonary Emphysema / Q000628:therapy; D014481:United States; D014486:United States Food and Drug Administration