51-year-old female hospitalized with right side empyema, a large-bore chest tube was placed, followed by a CT chest with contrast which showed residual fluid and trapped lung, she underwent VATS with decortication, unfortunately she developed severe subcutaneous emphysema and worsening pneumothorax, she went back to the OR for leak repair, she continued to have persistent air leak for 2 weeks. Occluding balloon was used to detect the specific airway(s) leading to the leak, two bronchial Spiration valves were deployed in the RML, the air leak resolved immediately, patient was discharged home day #2 post procedure with the chest tube in place and connected to a one-way valve. She was seen in the clinic 4 days later, where the chest tube was removed. We removed the valves few weeks later.
excellent job!! what was the cause of leak?