Case report

Use of endobronchial one-way valves reveals questions on etiology of spontaneous pneumothorax: report of three cases

Wai Cho Yu¹ , Yiu Cheong Yeung¹ , Yiu Chang¹ , Yuet Ling Tsang² , Kwok Chu Kwong¹ , Hau Chung Kwok¹ and YC Gary Lee³

¹  Department of Medicine & Geriatrics, Princess Margaret Hospital, Hong Kong

²  Central Endoscopy Unit, Princess Margaret Hospital Hong Kong, Hong Kong

³  University of Western Australia & Lung Institute of Western Australia, Sir Charles Gairdner Hospital, Perth, Australia

author email corresponding author email

Journal of Cardiothoracic Surgery 2009, 4:63doi:10.1186/1749-8090-4-63

Published:	7 November 2009

Abstract

Spontaneous pneumothoraces are believed to arise when air from the supplying airway exit via a ruptured visceral pleural bleb into the pleural cavity. Endobronchial one-way valves (EBVs) allow air exit (but not entry) from individual segmental airways. Systematic deployment of EBVs was applied to three patients with secondary spontaneous pneumothoraces and persistent airleak. In all cases, balloon-catheter occlusion of the upper lobe bronchus stopped the airleak. EBVs applied to individual upper lobe segmental airways failed to terminate the airleak, which only stopped after placements of multiple EBVs to occlude all upper lobe segments. The observation questions the traditional belief of 'one-airway-one-bleb-one-leak' in spontaneous pneumothorax.