A 69-year-old man with a diagnosis of COPD and severe emphysema, FEV1 0.58 Lts (25.1%) and RV 5.4 Lts (216%), with a pack-year index (API) of 45.
She was hospitalized due to progressive dyspnea, increased oxygen requirements until she required continuous NIV due to global respiratory failure.
Evaluation for LVRC was requested.
A chest X-ray (Rx) and CT scan of the chest revealed severe heterogeneous emphysema, predominantly in the right lower lobe (RLD), with apparently complete fissure.
The assessment of the endoscopic collateral ventilation was performed using the CHARTIS® system, which indicated the absence of collateral ventilation.
Three VE (Zephyr®) were installed in LID.
He had massive right lung pneumothorax 36 h after the procedure.
Pleural drainage 14 French was installed by percutaneous Seldinger technique, which was removed after 3 days.
No valve extraction was necessary.
The control chest X-ray at discharge (6 days after valve placement) showed complete right pulmonary expansion.
At 6 months of follow-up, the patient had an FEV1 0.87 Lts.7%), a VR 4.6 Lts test (18M St. George scoring system) scale of 68 to 31 points, a change of 3 observer
Clinically, it only requires supplementary oxygen during exercise.
