Lung Valve Helps Emphysema Sufferers to Breathe

A new umbrella-like valve may help patients with emphysema breathe easier, and may ultimately provide a noninvasive alternative to lung-volume-reduction surgery (LVRS).

Researchers from the Cleveland Clinic Foundation (OH, USA) and seven additional U.S. medical centers examined the safety and effectiveness of the IBV valve--a nonsurgical, investigational device--on patients with severe upper-lobe emphysema, a subtype of chronic obstructive pulmonary disease (COPD). Over a 27-month period, 520 valves were implanted in 75 patients across the medical centers. The valves were implanted in the upper lobes of the lung using flexible bronchoscopy, with an average of six to seven valves implanted per patient.

Of the patients who received valve treatment, 46 patients (group A) had reduced complications and retained efficacy compared with the remaining patients (group B). In responding patients, valve treatment transferred an average of 20% ventilation and perfusion to healthier regions of the lung. Compared with patients in group B, patients in group A were less than 75 years old, did not have lingular treatment, and had fewer lung segments treated. The 90-day serious complications were one bronchospasm and one COPD flare in the A group, and two bronchospasms and one death with pneumothorax in group B. The results were presented at the 72nd annual International Scientific Assembly of the American College of Chest Physicians, held in October 2006 in Salt Lake City (UT, USA).

The IBV valve was developed by Spiration (Redmond, WA, USA). The umbrella-shaped valves are placed in the lungs without an incision, using a flexible bronchoscope. The IBV valves are designed to redistribute air to healthier portions of the lung, and still allow the normal clearance of mucus to occur. By limiting airflow in parts of the diseased lungs, the remaining healthier portions of lung may function with better efficiency and improve the overall health status of the patient. The IBV valve is intended to be permanent but is designed to be removed, if necessary.

"Although valve treatment is still investigational, it may offer an alternative treatment for patients with emphysema who are not good candidates for LVRS,” said study co-author Atul C. Mehta, M.D., FCCP, of the Cleveland Clinic Foundation.



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