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1000
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Abstract/Summary
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<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>In COPD patients with severe right-sided emphysema, complete major and incomplete minor fissure, implantation of one-way valves in both the right upper (RUL) and middle lobes (ML) is a possible approach for endoscopic lung volume reduction. The aim of this retrospective analysis was to evaluate the response to therapy and the complication rate at 90 days (90d-FU) after combined RUL-ML valve implantation.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>This retrospective, monocentric study included all patients from the Thoraxklinik Heidelberg who underwent RUL-ML valve treatment between 2012 and 2023 with available follow-up data. Quantitative chest imaging, lung function, 6-minute walking distance (6-MWD), complications and indications for re-bronchoscopies until 90d-FU were analysed.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>28 patients underwent combined RUL-ML valve treatment, predominantly sequentially (92.86%, <jats:italic>n</jats:italic> = 26/28). Neither lung function nor 6MWD improved significantly in the overall cohort. However, in the subgroup with heterogeneous emphysema (71.4%, <jats:italic>n</jats:italic> = 20/28), FEV1 (Δ = 116.00 mL ± 195.77 mL, <jats:italic>p</jats:italic> < 0.05) and 6-MWD (Δ = 50.23 ± 69.10 m, <jats:italic>p</jats:italic> < 0.05) increased significantly at 90d-FU. Consistent with this, the baseline difference in emphysema volume between the RUL + ML and the right lower lobe correlated significantly with the increase in FEV1 at 90d-FU (<jats:italic>R</jats:italic> = 0.74, <jats:italic>p</jats:italic> < 0.001). Pneumothorax occurred in 5 cases in 4 patients (14.3%) following ML treatment. Severe pneumonia and/or COPD exacerbations occurred in 32.1% (9/28) of patients.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>Although only studied in a small cohort, our data suggest that combined RUL and ML valve implantation appears to be a promising interventional treatment strategy in patients with severe heterogenous RUL and ML emphysema.</jats:p>
</jats:sec>
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1000
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Hinweis
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DeepGreen-ID: cd106f5e259744ef8bbfa97018e6770d ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
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