Endobronchial Valves for Persistent Air Leak and Bronchopleural Fistula in Children: A Systematic Review of Indications, Procedural Approaches, and Outcomes.
Neha Mahindrakar, Prakreeti Bhandari, Ramya Yedatore et al.
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In 30 seconds
This systematic review examined bronchoscopic endobronchial or intrabronchial valve placement for persistent air leak, bronchopleural fistula, or pneumothorax with ongoing air leak in children and late adolescents. It included 13 reports comprising case reports, case series, and observational studies. In selected patients with varied underlying conditions, valve placement was associated with rapid or eventual improvement in air leak. Reported complications included valve migration or loosening, granulation tissue, minor hemoptysis, atelectasis, contralateral pneumothorax, and recurrent air leak. The authors characterize the evidence as low certainty.
Key findings
- Thirteen reports were included, covering pediatric or late-adolescent patients treated for persistent air leak, bronchopleural fistula, or pneumothorax with ongoing air leak.
- Valve placement was followed by rapid or eventual air-leak improvement in selected children across several clinical contexts.
- Reported complications included valve migration or loosening, granulation tissue, minor hemoptysis, atelectasis, contralateral pneumothorax, and recurrent air leak.
Why it matters
Persistent air leak and bronchopleural fistula can complicate serious pediatric illness or procedures. This review brings together reported experience with a bronchoscopic option when conservative treatment fails or surgery is high-risk. The findings suggest potential utility in selected cases, while the limited and heterogeneous evidence means outcomes and safety cannot be estimated reliably.
What to keep in mind
Evidence was low certainty because reports were small and retrospective, outcome definitions were inconsistent, and publication bias was possible.