Open AccessTemporary Right Middle Lobe Occlusion with a Blocking Device to Enable Collateral Ventilation Measurement of the Right Major Fissure
Author(s) -
Jorrit B A Welling,
T. David Koster,
Jorine E. Hartman,
Marlies van Dijk,
Huib A. M. Kerstjens,
Karin Klooster,
DirkJan Slebos
Publication year - 2020
Publication title -
respiration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.264
H-Index - 81
eISSN - 1423-0356
pISSN - 0025-7931
DOI - 10.1159/000507401
Subject(s) - medicine , lobe , occlusion , collateral circulation , balloon , surgery , cardiology , nuclear medicine , anesthesia , anatomy
Absence of interlobar collateral ventilation is essential to achieve lobar volume reduction after endobronchial valve (EBV) treatment and can be assessed using the Chartis measurement. However, especially in lower lobe measurements, Chartis can be complicated by the "no-flow phenomenon", during which a sudden cessation of flow is observed, leading to an unreliable measurement. If this phenomenon occurs in the right lower lobe, when measuring collateral flow over the right major fissure, the entrance to the right middle lobe should be occluded, and the Chartis balloon should be placed in the right upper lobe. Both Watanabe spigots and balloon catheters can be used to achieve occlusion.