Endobronchial valves for management of persistent air leak in advanced cystic fibrosis: A case report and review of literature

Patients with cystic fibrosis are at increased risk for secondary spontaneous pneumothorax. Persistent air leak in this population presents a unique therapeutic challenge given underlying structural lung disease and limited pulmonary reserve. We present a woman in her 20s with cystic fibrosis who developed a right-sided spontaneous pneumothorax complicated by a persistent air leak lasting 1 month despite management with a pleural catheter and autologous blood patch. To avoid surgical intervention, she underwent bronchoscopic placement of four endobronchial valves in the right upper and middle lobes, resulting in resolution of the air leak. The valves were removed 7 weeks later without complication. At 1 year follow up, she remained free of recurrent pneumothorax and had not required surgical intervention. This case highlights the potential role of endobronchial valves as a minimally invasive treatment option for persistent air leak in selected patients with cystic fibrosis. By providing a means of controlling the air leak while avoiding surgery, endobronchial valves may help preserve lung structure and future surgical options, including lung transplantation.