Endobronchial Valve Treatment for Persistent Air Leak and Endoscopic Lung Volume Reduction of Native Lung in a Single Lung Transplant Recipient: A Case Report and Literature Review

The use of endobronchial valves (EBV) is a recommended treatment for persistent air leak (PAL) and endoscopic lung volume reduction (ELVR) in selected patients with severe emphysema and absence of collateral ventilation. We report the case of a 52-year-old man who was scheduled for a bilateral sequential lung transplantation, converted to a left single lung transplantation (SLTx) after failure to remove the right lung due to prior thoracic surgery. The post-operative course was complicated by a PAL on the right non-transplanted side, unresponsive to prolonged drainage. Placement of EBV in the right upper and middle lobes, following collateral ventilation evaluation with the Chartis system, resulted in the resolution of the air leak and a concomitant lung volume reduction. Based on a literature review regarding ELVR in single-lung transplanted recipients, we suggest that ELVR with EBV could be a therapeutic option with an acceptable safety profile in this unique population.