Clinical Case of Prolonged Endobronchial Valve Treatment In Severe Chronic Obstructive Pulmonary Disease

Introduction. Endoscopic lung volume reduction (ELVR) with endobronchial valves is a minimally invasive technique used in severe emphysema-dominant chronic obstructive pulmonary disease (COPD). The procedure improves respiratory mechanics and reduces dyspnea by inducing atelectasis in hyperinflated lung segments without thoracotomy. ELVR is applied as palliative therapy or as a bridge to lung transplantation and can substantially improve quality of life in carefully selected patients. Segmental endobronchial valve therapy is now an established option for lung volume reduction in patients with upper-lobe-predominant emphysema and limited exercise tolerance.

Materials and methods. Case report. A 73-year-old patient with COPD, heterogeneous non-bullous emphysema, with severe upper-lobe predominance in the right lung, and grade 2 cor pulmonale had experienced multiple hospitalizations. ELVR was performed by placing endobronchial valves to achieve bronchial blockade of the right upper-lobe segments.

Results and discussion. The therapeutic effect of endobronchial valve therapy in COPD is achieved by restricting airflow to severely emphysematous regions. In this patient, segmental blockade of the right upper lobe reduced the severity of respiratory insufficiency and produced a meaningful improvement in quality of life.

Conclusion. Bronchoscopic lung-volume reduction with endobronchial valves is an effective approach for improving pulmonary function and exercise capacity in patients with severe COPD and upper-lobe-predominant emphysema.

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