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Endoluminal bronchial valves: a replacement for lung volume reduction surgery (LVRS) in chronic obstructive airways disease (COAD)?

Abstract

Full text: The benefit of LVRS in COAD is controversial because of a high complication rate. A potentially effective less invasive method may be endoluminal placement of one-way valves to block air entry and thus collapse affected lung zones. Our study assessed the physiological effects of this procedure. Three patients with severe COAD suitable for LVRS, underwent this procedure to both upper lobe main bronchi. Assessment included pre-and post-operative Tc-99m Technegas and quantitative Tc-99m macroaggregated albumin (MAA) studies, and also measurement of regional ventilation dynamics using Xe-133, ( 80 seconds wash-in / equilibration and a 3.5 minutes wash-out phase). The index of wash-in was Xe-133 counts at 20 sees /Xe-133 counts at 80 seconds. In all 6 treated upper lobes in patients with COAD substantial ventilation and perfusion persisted, and no radiographic collapse occurred. % perfusion to upper lung zones fell slightly from 27+12% to 21+8% (mean +SD): (P<0.05). The decreased wash-in index to the treated lobes shows a significant effect of the endoluminal valve. The increased washout rate from the lower lobes suggests therapeutic benefit. However preserved volume, ventilation and perfusion in the treated lobes suggest continuing aeration via interlobar ventilatory connections with the untreated lobes. Copyright (2002) The  More>>
Authors:
Salanitri, G C; Kalff, V; Kelly, M J; Snell, G; Williams, T [1] 
  1. Alfred Hospital, VIC (Australia). Departments of Nuclear and Respiratory Medicine
Publication Date:
Jul 01, 2002
Product Type:
Journal Article
Resource Relation:
Journal Name: ANZ Nuclear Medicine; Journal Volume: 33; Journal Issue: suppl.; Conference: 32. Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine, Cairns, QLD (Australia), 4-8 May 2002; Other Information: 1 tabs; PBD: 2002
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ALBUMINS; CLEARANCE; DYNAMIC FUNCTION STUDIES; LUNGS; PATIENTS; RADIOACTIVE AEROSOLS; RESPIRATORY SYSTEM DISEASES; TECHNETIUM 99; TRACER TECHNIQUES; VENTILATION; XENON 133
OSTI ID:
20382233
Country of Origin:
Australia
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1324-1435; ANMEFY; TRN: AU0322478061124
Availability:
Available in abstract form only, full text entered in this record;INIS
Submitting Site:
INIS
Size:
page(s) 20
Announcement Date:
Oct 01, 2003

Citation Formats

Salanitri, G C, Kalff, V, Kelly, M J, Snell, G, and Williams, T. Endoluminal bronchial valves: a replacement for lung volume reduction surgery (LVRS) in chronic obstructive airways disease (COAD)?. Australia: N. p., 2002. Web.
Salanitri, G C, Kalff, V, Kelly, M J, Snell, G, &amp; Williams, T. Endoluminal bronchial valves: a replacement for lung volume reduction surgery (LVRS) in chronic obstructive airways disease (COAD)?. Australia.
Salanitri, G C, Kalff, V, Kelly, M J, Snell, G, and Williams, T. 2002. "Endoluminal bronchial valves: a replacement for lung volume reduction surgery (LVRS) in chronic obstructive airways disease (COAD)?" Australia.
@misc{etde_20382233,
title = {Endoluminal bronchial valves: a replacement for lung volume reduction surgery (LVRS) in chronic obstructive airways disease (COAD)?}
author = {Salanitri, G C, Kalff, V, Kelly, M J, Snell, G, and Williams, T}
abstractNote = {Full text: The benefit of LVRS in COAD is controversial because of a high complication rate. A potentially effective less invasive method may be endoluminal placement of one-way valves to block air entry and thus collapse affected lung zones. Our study assessed the physiological effects of this procedure. Three patients with severe COAD suitable for LVRS, underwent this procedure to both upper lobe main bronchi. Assessment included pre-and post-operative Tc-99m Technegas and quantitative Tc-99m macroaggregated albumin (MAA) studies, and also measurement of regional ventilation dynamics using Xe-133, ( 80 seconds wash-in / equilibration and a 3.5 minutes wash-out phase). The index of wash-in was Xe-133 counts at 20 sees /Xe-133 counts at 80 seconds. In all 6 treated upper lobes in patients with COAD substantial ventilation and perfusion persisted, and no radiographic collapse occurred. % perfusion to upper lung zones fell slightly from 27+12% to 21+8% (mean +SD): (P<0.05). The decreased wash-in index to the treated lobes shows a significant effect of the endoluminal valve. The increased washout rate from the lower lobes suggests therapeutic benefit. However preserved volume, ventilation and perfusion in the treated lobes suggest continuing aeration via interlobar ventilatory connections with the untreated lobes. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc.}
journal = []
issue = {suppl.}
volume = {33}
journal type = {AC}
place = {Australia}
year = {2002}
month = {Jul}
}