Endobronchial Valves for Persistent Air Leak and Bronchopleural Fistula in Children: A Systematic Review of Indications, Procedural Approaches, and Outcomes

Persistent air leak (PAL) and bronchopleural fistula (BPF) are uncommon but important complications in children, particularly with necrotizing pneumonia, postoperative injury, malignancy, or extracorporeal membrane oxygenation (ECMO). When conservative therapy fails or surgery is high-risk, endobronchial or intrabronchial valve placement has emerged as a minimally invasive bronchoscopic option. This systematic review summarizes the published pediatric experience, focusing on indications, procedural approach, and outcomes.