Case report
Cardiac
Bronchoscopic Lung Volume Reduction in a Single-Lung Transplant Recipient With Natal Lung Hyperinflation: A Case Report

https://doi.org/10.1016/j.transproceed.2009.12.071Get rights and content

Abstract

After single lung transplantation for emphysema native lung hyperinflation is a common complication that may cause respiratory failure. Herein we have reported satisfactory bronchoscopic lung volume reduction in a left single-lung transplant recipient with native lung hyperinflation, who suffered from Medical Research Council (MRC) class 3 dyspnea and chest pain. Three endobronchial valves (Zephyr; Emphasys Medical, Redwood, Calif, United States) were placed into the segmental bronchi of the right upper lobe, using videobronchoscopy under general anesthesia. Postoperative chest computed tomography revealed subsegmental atelectasis in that lobe. The clinical benefit was an improved MRC dyspnea class from 3 to 2, which was still present at 4 months after the procedure, although there were no remarkable changes in spirometric parameters.

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Case Report

A 60-year-old woman (73 kg; 173 cm) with smoking-related emphysema underwent left SLT 10 years ago. Although LVRS (atypical resection) was performed in the right lung at the same procedure, she developed NLH. She had a history of progressive dyspnea over the last year, which had worsened until it became MRC class 3, so she was scheduled for BLVR. Her medical history revealed arterial hypertension, dyslipidemia, hyperuricemia an anxiety syndrome, and deep vein thrombosis 13 years ago. Her

Discussion

NLH represents a substantial problem in SLT patients with emphysema. Sometimes the treatment is difficult.2 LVRS has proven valuable in heterogeneous emphysema; nevertheless, it poses a high risk among severely ill patients.4, 6 In contrast, BLVR is a relatively simple procedure with low morbidity and no reported mortality.10 It is also potentially reversible,8 which, in our opinion, is an important issue because atelectasis can result in a respiratory imbalance. Despite these benefits, BLVR

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