Presentation
Increased work of breathing and cough, decreased air entry bilaterally with expiratory wheeze loudest over the right base. Known severe COPD on home oxygen, FEV1 0.75L (25% predicted), DLCO 55% predicted.
Patient Data
The lungs are severely emphysematous but no consolidation or pleural collection is demonstrated. Right lower lobe endobronchial valves are noted. Bilateral lower zone atelectasis or scarring. Heart size and cardiomediastinal contours are normal.
Case Discussion
Endobronchial valves reduce the flow of air into the treated lobe during inspiration whilst allowing secretions and air to be expelled from that region during expiration. Its intention is to cause localized atelectasis in the target lobe, matching the size of the lungs to the size of the thorax containing them, thereby causing improvement in lung function, exercise tolerance, dyspnea, and quality of life.
Acknowledgement: Dr Theodore Lau
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