PT - JOURNAL ARTICLE AU - Ralf Eberhardt AU - Daniela Gompelmann AU - Felix J.F. Herth AU - Arschang Valipour AU - Armin Ernst AU - Gerard J. Criner AU - Dirk-Jan Slebos TI - Outcome of endobronchial valve (EBV) placement in lower lobes and in low heterogeneous patients DP - 2012 Sep 01 TA - European Respiratory Journal PG - 4729 VI - 40 IP - Suppl 56 4099 - http://erj.ersjournals.com/content/40/Suppl_56/4729.short 4100 - http://erj.ersjournals.com/content/40/Suppl_56/4729.full SO - Eur Respir J2012 Sep 01; 40 AB - IntroductionVENT and Chartis studies showed clinical benefit when EBV's (PulmonX, CA, USA) are placed to achieve lobar occlusion in patients with complete fissures/absent collateral ventilation. There was no restriction on site of valve placement and patients with a range of heterogeneity scores were treated.ObjectiveTo evaluate clinical outcomes in patients treated with EBV in lower lobes and in patients with low heterogeneity.MethodsAnalysis of the VENT subgroup with complete fissures with lobar occlusion and analysis of patients in the Chartis study with absent collateral ventilation and who achieved target lobe volume reduction of > 350ml.ResultsIn the Chartis subgroup, 12 patients were treated in left lower lobe (LLL) with a % improvement in FEV1 at 30 days of 17.5% ±20.8 and SGRQ of -14.6 points ±14.4. Five patients were treated in right lower lobe (RLL) with a Δ FEV1 of 40.7% ±27.4 and a Δ SGRQ of -18.6 points ±15.2. In the VENT subgroup, 11 patients were treated in LLL, resulting in a ΔFEV1 at 6 and 12 months of 18.1% ±20.0 and 13.1% ±20.2 respectively. In the 4 RLL patients, ΔFEV1 was 22.9% ±22.8 and 23.6% ±15.8. Δ SGRQ was -7.5 points ±19.1 and -7.5 ±15.0 at 6 months in LLL and RLL respectively.In the VENT subgroup, 26 patients had heterogeneity score of ≤15% with a mean change in FEV1 at 12 months of 15.4% ±25.1 compared to 31.1 ±28.8 in the 35 patients with a score > 15%. In the Chartis subgroup, 14 had a score of ≤15% and showed a mean change in FEV1 of 15.9% ±16.1 at 30 days compared to 26.4% ± 27.9 in the 20 patients with a score > 15%.ConclusionA clinical relevant response can be obtained after EBV in lower lobes and in patients who are not highly heterogeneous.