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Determining collateral ventilation during bronchoscopy: unanswered questions
  1. Wolfgang Gesierich1,
  2. Konstantinos Samitas1,2,
  3. Juergen Behr1
  1. 1 Klinik für Pneumologie, Asklepios Fachkliniken München-Gauting, Comprehensive Pneumology Center, Gauting, Germany
  2. 2 7th Respiratory Department and Asthma Centre, Athens Chest Hospital “Sotiria”, Athens, Greece
  1. Correspondence to Dr Wolfgang Gesierich, Asklepios Fachkliniken München Gauting, Comprehensive Pneumology Center, Robert-Koch-Allee 2, Gauting D-82131, Germany; w.gesierich{at}

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In their recent review, Shah et al 1 made an excellent presentation of the latest perspectives of lung volume reduction with endobronchial valves, emphasising the importance of collateral ventilation (CV) and fissure analysis on selecting proper candidates, as shown in the VENT studies.2 ,3 The authors described representative cases of patients with positive and negative CV using the Chartis system4 and recommended that persistence of flow after 5 min of balloon inflation, particularly where more than a litre of air has been expelled, suggests the presence of significant CV.

Our centre has extensive experience in evaluating CV with Chartis. We agree with Dr Shah and colleagues on their clear definition of positive CV. We feel, however, that the accurate assessment of negative CV is not always …

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  • Contributors WG, KS and JB conceived the idea. WG and KS drafted the first version of the manuscript. KS prepared figure graphics. JB revised the manuscript and made substantial intellectual contributions. All authors approved the final version of the manuscript. WG is responsible for the overall content as guarantor.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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