Bronchoscopic Lung Volume Reduction for Severe Chronic Obstructive Pulmonary Disease Complicated by an Airway Foreign Body: A Case Report

Abstract

Bronchoscopic lung volume reduction (BLVR) is a minimally invasive treatment for severe chronic obstructive pulmonary disease (COPD). However, its efficacy and safety in cases complicated by airway foreign bodies remain unclear. We report the case of a 72-year-old man with severe COPD who had a denture lodged in the left B6 segment and for whom general anesthesia was considered high-risk. After confirming the absence of collateral ventilation in the right lower lobe using the Chartis system, Zephyr valves were placed in the right B6-B10 segments. Postoperatively, collapse of the right lower lobe and re-expansion of the right upper and middle lobes were confirmed, which was associated with a significant improvement in forced expiratory volume in 1 second. At the 12-month follow-up, no adverse events, including pneumothorax or COPD exacerbation, were observed. This case suggests that BLVR can be performed safely and effectively, even in patients with severe COPD complicated by an airway foreign body, provided that appropriate evaluation and careful target lobe selection are undertaken.