Bronchopleural Fistula and Endobronchial Valve Placement in a Patient With COVID-19 Pneumonia: A Case Report With Literature Review

Abstract

Bronchopleural fistulas (BPFs) are associated with high morbidity and mortality. Though most commonly seen after surgical interventions, they are increasingly reported as complications of COVID-19 infection. We present the case of an 86-year-old man with COVID-19 pneumonia and subsequent bronchopleural fistula (BPF) with persistent air leak. Endobronchial valves were placed in apical and posterior segments of the right upper lobe resulting in successful cessation of the air leak. The purpose of the case report and literature review is to help guide the management of persistent air leak.

Bronchopulmonary Fistula Development in an Elderly Male With COVID-19 Infection

“…In the current literature, there are various treatment options for a BPF secondary to COVID-19. The overall theme includes minimally invasive techniques including chest tube placements, endobronchial valves, and rarely surgical considerations [7][8][9]. In this case, a minimally invasive approach utilizing a VATS procedure was successfully used for a debilitated patient suffering from a non-surgical etiology of his BPF.…”

“…Typically, BPF is seen in the setting of postoperative lung resection; however, other causes include bullous disease, tuberculosis, and radiation therapy [ 5 ]. Now, more recently, COVID-19 pneumonia has been identified as another etiology for BPF [ 7 ].…”