Endobronchial valve to treat large bulla at right middle lobe in chronic obstructive pulmonary disease patients

We have used endobronchial valve (EBV) to treat large bulla at right middle lobe (RML) on three chronic obstructive pulmonary disease (COPD) patients and presented the clinical datum of three COPD patients with RML bulla. The improvement of lung function was significant on two patients, whose lung parenchyma was preserved well in lobes other than RML. On one patient, whose lung function did not show improvement after EBV treatment, the parenchyma of bilateral lungs was destructed heavily by chronic inflammation of COPD, and the RML bulla did not collapse because right major and/or minor fissures are incomplete. EBV may be used to treat large RML bulla in selected patients, whose parenchyma of other parts of the lung was conserved well and right major and minor fissures are complete.