PMC6176309_01
CT-scan (left image) and chest X-ray (right image) on day 16 before endobronchial valve placement: large pneumothorax despite three chest drainages on the left (white arrows).
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CT-scan on day 16 showed a complete, left-sided pneumothorax (Figure 1). Central venous catheter placement on the left (internal jugular vein) was performed six days before the onset of the air leak.
CT-scan (left image) and chest X-ray (right image) after endobronchial valve placement. The left lung is again fully expanded. The circled areas depict the two endobronchial valves within the left upper lobe segmental bronchi (LB1/2 and LB3). The Avalon Elite  Bi-Caval Dual Lumen Catheter is visible on the chest X-ray (white arrow).
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This initially led to an immediate decrease of the air leak to about 400-700 ml/min, and the left lung was then again fully expanded (Figure 2).
Chest X-ray (left image) after removal of the endobronchial valves (right image).
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Removal of the endobronchial valves occurred on day 62, after which the chest X-rays showed a persistently expanded left lung (Figure 3).