Faculty Collaboration Database

A multicenter pilot study of a bronchial valve for the treatment of severe emphysema. Respiration 2010;79(3):222-33

Date

11/20/2009

Pubmed ID

19923790

Pubmed Central ID

PMC7068788

DOI

10.1159/000259318

Scopus ID

2-s2.0-76749171135 (requires institutional sign-in at Scopus site)   130 Citations

Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) affects millions of people and has limited treatment options. Surgical treatments for severe COPD with emphysema are effective for highly selected patients. A minimally invasive method for treating emphysema could decrease morbidity and increase acceptance by patients.

OBJECTIVE: To study the safety and effectiveness of the IBV(R) Valve for the treatment of severe emphysema.

METHODS: A multicenter study treated 91 patients with severe obstruction, hyperinflation and upper lobe (UL)-predominant emphysema with 609 bronchial valves placed bilaterally into ULs.

RESULTS: Valves were placed in desired airways with 99.7% technical success and no migration or erosion. There were no procedure-related deaths and 30-day morbidity and mortality were 5.5 and 1.1%, respectively. Pneumothorax was the most frequent serious device-related complication and primarily occurred when all segments of a lobe, especially the left UL, were occluded. Highly significant health-related quality of life (HRQL) improvement (-8.2 +/- 16.2, mean +/- SD change at 6 months) was observed. HRQL improvement was associated with a decreased volume (mean -294 +/- 427 ml, p = 0.007) in the treated lobes without visible atelectasis. FEV(1), exercise tests, and total lung volume were not changed but there was a proportional shift, a redirection of inspired volume to the untreated lobes. Combined with perfusion scan changes, this suggests that there is improved ventilation and perfusion matching in non-UL lung parenchyma.

CONCLUSION: Bronchial valve treatment of emphysema has multiple mechanisms of action and acceptable safety, and significantly improves quality of life for the majority of patients.

Author List

Sterman DH, Mehta AC, Wood DE, Mathur PN, McKenna RJ Jr, Ost DE, Truwit JD, Diaz P, Wahidi MM, Cerfolio R, Maxfield R, Musani AI, Gildea T, Sheski F, Machuzak M, Haas AR, Gonzalez HX, Springmeyer SC, IBV Valve US Pilot Trial Research Team

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Blood Gas Analysis
Bronchoscopy
Device Removal
Exercise Test
Female
Humans
Lung Volume Measurements
Male
Middle Aged
Oxygen
Pilot Projects
Pneumonia
Pneumothorax
Postoperative Complications
Prospective Studies
Prostheses and Implants
Pulmonary Circulation
Pulmonary Emphysema
Quality of Life
Tomography, X-Ray Computed
Treatment Outcome
United States