Original articleGeneral thoracicBronchoscopic Lung-Volume Reduction With One-Way Valves in Patients With Heterogenous Emphysema
Section snippets
Material and Methods
We conducted a prospective, nonrandomized, single-center longitudinal study to evaluate the safety and short-term efficacy of BLVR performed by placing one-way endobronchial valves (Emphasys, Redwood City, CA) in the bronchi supplying the most hyperinflated parts of the emphysematous lungs. Thirteen patients (12 men, 1 woman; median age, 56 years; range, 32 to 71) entered this pilot study during a 14-month period.
Results
Fifty-nine valves were placed (median 4 per patient; range 2 to 6); the devices were placed in the right upper lobe in 6 treatments (40%), in the right upper and middle lobe in 1 (7%), in the left upper lobe in 3 (20%), and in the right and left lower lobes in 3 (20%) and 2 (13%) cases, respectively. The median operative time was 45 minutes (range 20 to 95 minutes). No intraoperative complications were observed.
All patients were extubated immediately after the procedure and returned to the
Comment
Surgical lung-volume reduction (LVRS) can now be considered an effective palliation for a selected group of patients with advanced emphysema 6, 7. It provides improved pulmonary function, quality of life, and exercise tolerance 16, 17 with an accepted mortality of 5% to 10% [18]. Morbidity has still an impact, with a significant percentage of patients showing prolonged air leaks 16, 18. LVRS is not always indicated, however. In fact, patients with the most advanced disease show a higher
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