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Ann Thorac Surg 2000;70:1211
© 2000 The Society of Thoracic Surgeons

Invited commentary

Invited commentary

Roger D. Yusen, MDa

a Divisions of Pulmonary and Critical Care Medicine and General Medical Sciences, Washington University School of Medicine, St. Louis, MO 63110-1093, USA,

e-mail: yusenr@msnotes.wustl.edu

Baldwin and colleagues found a significant correlation between preoperative emphysema heterogeneity and change in forced expiratory volume in 1 second (FEV1) after bilateral excisional lung volume reduction surgery. Heterogeneity was determined by grading chest radiographs according to defined criteria. The severity of emphysema was assessed, and the difference in severity scores between the total scores of the two worst quadrants and the total scores of the two best quadrants determined the heterogeneity index. Although the authors determined heterogeneity from a radiologic standpoint, the severity of emphysema in potential surgical resection sites and nonresection sites was the issue at hand. For example, large areas of mostly destroyed emphysematous lung provided "target areas" . . . [Full Text of this Article]


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Chest radiograph heterogeneity predicts functional improvement with volume reduction surgery
John C. Baldwin, Charles C. Miller, III, Rebecca A. Prince, and Rafael Espada
Ann. Thorac. Surg. 2000 70: 1208-1211. [Abstract] [Full Text] [PDF]





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