Pre Lung Volume Reduction Surgery/Endobronchial Valve Placement

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<RequestCaseHistory> <RequestReason>
Report:
Presence of emphysema: [Yes/No.] Type of disease: [centrilobular] [, paraseptal] [, panlobular] [, bullous] Location/distribution of severity: [Heterogenous (Focal)/Homogenous (diffuse)/state lobar predominance/Size of bulla] Pleural disease: [Yes/No. Type] Fissures: [Complete/Incomplete, which and amount] Bronchiectasis: [Yes/No]. Signs of pulmonary hypertension: [Yes/No]. Fibrosis: [Yes/No]. Lung nodules: [Yes/No]. Bones/thoracic cage: [Yes/No]. Extra-pulmonary findings: [].

Explantory notes

Heading	Options	Reason
Presence of emphysema:	Yes/No.
Type of disease:	centrilobular, paraseptal, panlobular, bullous
Location/distribution of severity:	Heterogenous (Focal)/diffuse/state lobar predominance	Upper lobe predominance or focal disease responds better to this treatment.
Pleural disease:	Yes/No. Type	This may inhibit lung expansion.
Fissures:	Complete/Incomplete, which and amount	This is relevant to the placement of bronchial valves, collateral air drift may prevent intended collapse. A complete fissure in one demonstrating integrity across 90% or more between separated lobes and this correlates with better outcomes. Collateral ventilation may also be assessed bronchoscopically.
Bronchiectasis:	Yes/No.	This is a separate disease process that would only benefit from resection in its own right and with different benefits e.g. reduced infective episodes as opposed to improved respiratory function. Presence in lung spared from emphysema indicates abnormal lung.
Signs of pulmonary hypertension:	Yes/No.	LVRS may increase pulmonary arterial hypertension.
Fibrosis:	Yes/No. Type. Location	Interstitial disease may inhibit re-expansion.
Lung nodules:	Insert options here	In some cases resection and LVRS may be appropriate and beneficial.
Bones/thoracic cage:		Any restrictive thoracic cage abnormality should be noted.
Extra-pulmonary findings:

References:

1. Washko GR, Hoffman E, Reilly JJ. Radiographic evaluation of the potential lung volume reduction surgery candidate. Proc Am Thorac Soc. 2008;5(4):421-6.
2. Coxson HO, Whittall KP, Nakano Y, et al. Selection of patients for lung volume reduction surgery using a power law analysis of the computed tomographic scan. Thorax. 2003;58(6):510-4.
3. Criner GJ, Scharf SM, Falk JA, et al. Effect of lung volume reduction surgery on resting pulmonary hemodynamics in severe emphysema. Am J Respir Crit Care Med. 2007;176(3):253-60.
4. Am J Respir Crit Care Med. 1999 Feb;159(2):552-6. Development of pulmonary hypertension after lung volume reduction surgery. Weg IL1, Rossoff L, McKeon K, Michael Graver L, Scharf SM.
5. DeCamp MM, Lipson D, Krasna M, Minai OA, McKenna RJ, Thomashow BM. The evaluation and preparation of the patient for lung volume reduction surgery. Proc Am Thorac Soc. 2008;5(4):427-31.
6. Patients at High Risk of Death after Lung-Volume–Reduction Surgery October 11, 2001 N Engl J Med 2001; 345:1075-1083 DOI: 10.1056/NEJMoa11798
7. Eberhardt R, Gompelmann D, Herth FJ, Schuhmann M. Endoscopic bronchial valve treatment: patient selection and special considerations. Int J Chron Obstruct Pulmon Dis. 2015;10:2147-57. Published 2015 Oct 8. doi:10.2147/COPD.S63473
8. Endobronchial valve insertion to reduce lung volume in emphysema | Guidance and guidelines | NICE https://www.nice.org.uk/guidance/ipg600
9. Multicentre European study for the treatment of advanced emphysema with bronchial valves Vincent Ninane, Christian Geltner, Michela Bezzi, Pierfranco Foccoli, Jens Gottlieb, Tobias Welte, Luis Seijo, Javier J. Zulueta, Mohammed Munavvar, Antoni Rosell, Marta Lopez, Paul W. Jones, Harvey O. Coxson, Steven C. Springmeyer, Xavier Gonzalez European Respiratory Journal Jun 2012, 39 (6) 1319-1325; DOI: 10.1183/09031936.00019711
10. Browning RF, Parrish S, Sarkar S, et al. Bronchoscopic interventions for severe COPD. J Thorac Dis. 2014;6(Suppl 4):S407-15.