Lung volume reduction surgery is a therapeutic option for selected patients with advanced emphysema. However, it is an invasive procedure benefitting only a selected group of patients with heterogenous upper lobe predominant disease and limited exercise capacity. The most widely studied alternatives are endobronchial valves. Hundreds of patients worldwide have undergone endobronchial valve placement. Although short-term outcomes have been described, little is known about the long-term side effects following this treatment, and endoscopic follow-up is virtually nonexistent. The images, biopsies, and microbiologic evidence accrued from this patient are witnesses to the natural evolution of endobronchial valves in the airways and should offer a word of caution with regard to valve placement in patients with life expectancies exceeding those typical of severe chronic obstructive lung disease.
*Pulmonary Department, Clínica Universidad de Navarra, Pamplona
†Pulmonary Department, IIS—Fundación Jimenez Díaz—CIBERES, Madrid, Spain
Disclosure: There is no conflict of interest or other disclosures.
Reprints: Luis M. Seijo, MD, Médico Adjunto, Servicio de Neumología, IIS—Fundación Jiménez Díaz—CIBERES, Avda de los Reyes Catolicos 2, Madrid 28040, Spain (e-mail: firstname.lastname@example.org).
Received May 24, 2013
Accepted November 13, 2014