Patient experiencing air leak had three spiration valves placed in left upper lobe: size 7 in apical; size 7 in anterior; size 6 in apical posterior.After discharge from hospital, patient developed covid-19 and post-op appointment was delayed.Patient was subsequently scheduled for valve removal.Healthcare provider was able to easily visualize two of the valves in the left upper lobe, and successfully remove the size 7 in the apical and size 7 in the anterior segments, but had difficulty visualizing the size 6 in the apical posterior segment.Using a pediatric bronchoscope the healthcare provider could see that the valve had migrated distally and attempted numerous times to grasp the valve and retrieve it, but was unsuccessful.At this time, it was deemed best to hold the procedure and have the patient get repeat imaging to evaluate the valve location.Following repeat ct chest scan, healthcare provider decided not to remove the valve as a possible thoracotomy may be required.
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