Lung valves, also known as endobronchial valves (EBV), are a relatively new treatment for people with severe emphysema. Emphysema is a lung condition that falls under the umbrella of chronic obstructive pulmonary disease (COPD).

Emphysema happens due to the destruction of tiny air sacs in the lungs called alveoli. This greatly affects the exchange of vital oxygen and carbon dioxide in the lungs.

Continue reading to learn more about lung valves, how they work for emphysema, and who is a good candidate for this treatment.

With emphysema, air can become trapped in damaged areas of the lungs. This can cause the worst affected areas of the lung to become larger and press on healthy lung tissue. This makes it harder to breathe and can result in your body not getting enough oxygen.

Lung valves are medical devices that are implanted into the most damaged areas of the lungs. They’re small, about the size of a pencil eraser, and they only let the air flow one way.

Lung valves help control the flow of air in lungs that have been damaged by emphysema. They prevent air from entering the most damaged areas while allowing air that’s become trapped in these areas to escape.

A procedure called endobronchial valve placement involves collapsing the most damaged areas of the lung with the placement of one-way valves. By doing this, it makes it easier for the diaphragm and chest wall to move as they should.

Basically, by not having big, damaged areas of the lung getting in the way of breathing, it allows more space in the chest for healthier parts of the lung to work. This can make it easier for people with emphysema to breathe.

This is a reversible procedure and has a similar effect as surgically removing the damaged part of the lung, but it’s a less invasive procedure.

Lung valves were first approved by the Food and Drug Administration (FDA) in 2018 for the treatment of severe emphysema.

One of the potential treatment options for people with severe emphysema is the use of medications, such as bronchodilators and inhaled corticosteroids. These help to open the airways and lower inflammation, respectively.

For some individuals, medications aren’t very effective at managing emphysema symptoms. Doctors may recommend surgery for these people. Surgery can involve the removal of damaged lung tissue or a lung transplant.

However, surgical interventions may not be an option for all people with severe emphysema. The use of lung valves is a less invasive, reversible approach that can help improve symptoms.

A 2018 clinical trial found that treatment with lung valves was more effective at improving lung function than standard care alone. In this case, standard care refers to the use of medications and pulmonary rehabilitation.

The trial included 190 people with severe emphysema. A total of 128 people received both lung valves and standard care while 62 people received standard care only.

After 12 months, 47.7 percent of individuals who received lung valves had at least a 15 percent improvement in their lung function. This is compared with only 16.8 percent of those in the study who received standard care only.

So far, the effectiveness of lung valves compared with surgery is unknown. However, a clinical trial to evaluate this question is currently underway.

Lung valves are placed inside the lungs during a procedure called endobronchial valve placement or bronchoscopic lung volume reduction (BLVR). This procedure takes place in a hospital and generally takes less than 1 hour.

A bronchoscope — a thin, flexible tube that has a camera on the end — is used to position the lung valves. Your doctor will thread the bronchoscope into your airways until it reaches the target area. Once in the right area, the valves will be placed into the airway.

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Illustration by Sophia Smith

It’s likely that you’ll have multiple valves placed in your lungs. Typically, three to five lung valves are placed during a procedure.

You’ll be sedated while your doctor positions the valves in the right places. In some cases, general anesthesia may be used, meaning that you’ll be asleep during the procedure.

After your procedure, you’ll likely need to stay in the hospital for 3 to 5 days. This allows your healthcare team to make sure the valves are working properly and that there aren’t any complications.

After your lung valves have been inserted, you’ll continue to take your emphysema medications as directed by your doctor. You may also get a prescription for a course of antibiotics to prevent a lung infection.

As a lung valve recipient, you’ll also receive a patient information card. It’s important to keep this card with you at all times. Show it to anyone who is providing you with medical care, so they know you have valves in your lungs.

It’s also possible that you may need to have a second procedure to adjust the placement of your valves or to address side effects. It’s estimated that 1 in 5 people will require a second procedure.

Some of the potential risks of lung valve placement include:

It’s important to carefully monitor your symptoms in the days and weeks after your procedure. Get immediate medical care or call 911 if you notice symptoms like:

Doctors recommend the placement of lung valves for people with severe emphysema whose lungs have increased in size due to trapped air.

Good candidates have areas of lung damage that can be effectively blocked off with the placement of these endobronchial valves.

Valve placement targets certain damaged portions of the lung for collapse. However, in some people with emphysema, airflow can still access these areas. This is called collateral ventilation. The absence of collateral ventilation is critical for the success of lung valve treatment.

Before recommending treatment with lung valves, your doctor will perform tests to check that this procedure is right for you. These tests may include a CT scan of your lungs and lung function tests.

In addition to collateral ventilation, there are other instances when lung valves aren’t recommended for people with emphysema. This includes individuals who:

  • have not stopped smoking
  • currently have a lung infection
  • cannot have a bronchoscopic procedure
  • have an allergy to any of the components used in lung valves
  • have an air pocket, also known as a bulla, that takes up over 1/3 of the lung

If you have emphysema and would like to learn more about lung valves, talk with your doctor or pulmonologist. They can give you more information about the procedure and help determine whether it’s a good option for you.

Lung valves help to control airflow in the lungs of people with severe emphysema. Clinical studies have shown that lung valves can be more effective than standard care alone in certain people. They’re also a less invasive option than surgery that involves the removal of damaged lung tissue or a lung transplant.

Placing lung valves involves a bronchoscopic procedure and hospital stay. If you’re interested in lung valves as a treatment option for your emphysema, ask your doctor for more information about the procedure and whether you may be a suitable candidate for this treatment.