A case of 58 years old male PINK Puffer with very limited performance status. Pulmonary function Tests can not be done. They are going to do CABG 3 Vessels for him. They are wondering if he can benefit from lung volume reduction surgery.
Patient had only 3 months treatment with anti TB. Pulmonologists stratified him as a high risk for CABG alone. Is he going to benefit from Lung Volume reduction surgery simultaneous with CABG?
The image you have uploaded shows cavitary lesion with fibrosis which is most likely sequelae of old pulmonary tuberculosis . There is no such emphysematous changes or bullous lesion which may improve patient's functional status following LVRS. In my opinion, there is no need to go through both procedures as these are going to add further risk of mortality and post operative morbidity.
I suggest first percutaneous chest drainage of major bullae, then perform pleurodesis. In the case of procedure failure, Surgical thoracoscopic bullectomy can be done.
In my opinion, there is no need to go through surgical procedures as these are going to add further risk of mortality , percutaneous chest drainage may be of benefit.
In my opinion, there is no need to go through surgical procedures as these are going to add further risk of mortality , percutaneous chest drainage may be of benefit.
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