PMC5288453_01
Lung function versus time.
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These functional improvements mirrored significant changes in lung physiological measures (Fig. 1). SLVR was considered the most appropriate strategy. Surgery was uncomplicated; the patient was discharged after 7 days, and has remained well with again a useful improvement in lung function (Fig. 1, Fig. 3).
Serial chest X-rays. A) Pre-all procedures. B) Early post-left upper lobe bronchoscopic lung reduction. C) Late post-left upper lobe bronchoscopic lung reduction. D) Early post-right upper lobe surgical lung reduction. Note movement of mediastinum and changing volume of lower lobes.
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Serial chest x-rays as shown in Fig. 2, demonstrate significant mediastinal movement and volume change with BLVR.
Changes in lobar volumes versus time.
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Software calculated lobar volume changes (Vida Diagnostics Inc, Coralville, IA) are shown in Fig. 3. With a slow recurrence of exercise limitation, consistent physiological measures (FEV1 31% predicted, 6MWD 230m, increasing hyperinflation) (Fig. 3) and an untouched potential obvious unilateral RUL target, a second procedure was considered 7 years after the first.