title: Endobronchial Treatment of Bronchopleural Fistulas by Using Intrabronchial Valve System: A Case Series.
abstract: Air leaks, alveolopleural or bronchopleural fistulas, either spontaneous, iatrogenic, or postsurgical, can be difficult to treat, and if prolonged in spite of proper chest tube thoracostomy they may require surgical or chemical pleurodesis with variable success. Intrabronchial valve (IBV) treatment is minimally invasive and has a potential to shorten the duration of air leaks in well-selected patients with ongoing air leaks. The study included 19 patients with prolonged air leaks treated with IBVs spiration, with a total of 71 valves placed at a tertiary university hospital. Internal Board Review approval was obtained to use IBVs for off-label indication. IBVs were placed in desired airways with 100% accuracy in patients with air leaks without complications, including self-migration. All 19 patients with air leaks were initially treated with chest tube thoracostomy and in addition chemical pleurodesis in 2 and blood patch in a patient without success. After IBV placement, all patients but one with air leak had successful resolution of the air leak and removal of chest tube in a median of 3 days (range: 2-45 days). In conclusion, the use of IBVs for prolonged air leaks in various etiologies is effective and safe.
authors.affiliation: Division of Cardiothoracic Surgery, Section of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minnesota. Electronic address: eitanp@umn.edu.
authors.forename: Eitan
authors.initials: E
authors.lastname: Podgaetz
authors.affiliation: Division of Cardiothoracic Surgery, Section of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Andrade
authors.affiliation: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Felix
authors.initials: F
authors.lastname: Zamora
authors.affiliation: Cardiopulmonary Service, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Heidi
authors.initials: H
authors.lastname: Gibson
authors.affiliation: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: H Erhan
authors.initials: HE
authors.lastname: Dincer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001983:Bronchial Fistula / Q000175:diagnosis / Q000601:surgery*; D001999:Bronchoscopy / Q000009:adverse effects / Q000295:instrumentation*; D015505:Chest Tubes; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000175:diagnosis / Q000601:surgery*; D011030:Pneumothorax / Q000175:diagnosis / Q000601:surgery*; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000601:surgery*; D013907:Thoracostomy / Q000295:instrumentation; D013997:Time Factors; D016896:Treatment Outcome
keywords: Alveolopleural fistula; Bronchopleural fistula; IBV valve; bronchoscopic; prolonged air leak