Background: In this study, we evaluated the efficacy of the Heimlich valve used for prolonged air leaks and pleural space in patients undergoing surgery for any reason.

Methods: Between August 2009 and March 2012, the Heimlich valve was applied to 26 patients with prolonged air leaks and persistent pleural space who were operated for any reason in our clinic. Patients were discharged after the evaluation of posteroanterior chest X-ray performed four hours after the intervention and scheduled for weekly visits with repeated posteroanterior chest X-ray. Tube thoracostomy was ended in patients in whom airfluid drainage was cut without residual pleural space or with an acceptable degree of aseptic pleural space. The intervention was regarded as successful, if the lungs were fully expanded or patients needed no additional intervention.

Results: The Heimlich valves were inserted using the chest tubes 8-30 days after the operation and the patients were discharged. The mean removal time was 18 (range, 3 to 60) days. Complete expansion was observed in 19 patients (73%), while an acceptable degree of aseptic pleural space was found at the apex in five patients (19.2%) and in the laterobasal region in two patients (7.69%). The intervention failed in only one patient due to a large pleural space. The patient was reoperated and the space was obliterated with pectoral muscle flap.

Conclusion: Persistent pleural space and prolonged air leaks are the most challenging problems for thoracic surgeons. The Heimlich valve is a safe and effective treatment modality in patients with such problems.

Keywords : Heimlich valve; pleural space; prolonged air leak