• Racha Boulos, Karina Anam, Sujatha Bhandary, Jonathan Tang, Christian Ghattas, Lindsay Wright, Nicholas Pastis, Alberto Revelo, Hatem Mowafy, Michael Essandoh, and Hamdy Awad.
• Department of Anesthesiology, Ohio State University, Columbus, Ohio. Electronic address: Racha.boulos1@outlook.com.
• J. Cardiothorac. Vasc. Anesth. 2023 Oct 1; 37 (10): 210921132109-2113.

AbstractEndobronchial valves (EBVs) are a novel, minimally invasive bronchoscopic management technique for persistent air leaks that fail conservative therapy. Currently, 2 EBVs are available in the United States: the Spiration Valve System (Olympus, Redmond, WA) and the Zephyr Valve (Pulmonx, Redwood, CA). These valves are Food and Drug Administration-approved to reduce hyperinflation in emphysematous patients via bronchoscopic lung-volume reduction. However, more recently, the Spiration Valve has been granted a compassionate use exemption through the Food and Drug Administration for persistent postsurgical air leaks. Despite their popularity, these devices are not free from side effects. As an anesthesiologist, it is vital to be aware of the pathophysiology of this patient population so that safe and effective anesthetics may be provided during valve placement. Here, the use of EBVs is discussed in a patient who presented with a persistent air leak after a transthoracic needle aspiration that failed treatment due to persistent hypoxemia, warranting EBV removal.Published by Elsevier Inc.

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