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"Umbrella" Valve Provides Potential Alternative to Lung Surgery

f the lung using flexible bronchoscopy, with an average of 6 to 7 valves implanted per patient. Researchers used quantitative software and multidetector CT scans to measure the physical effects of the valves and the St. George Respiratory Questionnaire (SGRQ) to assess how patients felt after treatment.

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 percent ventilation and perfusion to healthier regions of the lung. Two thirds of patients in group A also had a 4-point or more SGRQ improvement at 6 months and showed significant improvements in oxygen use and DLCO. 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 bronchospasm and one death with pneumothorax in group B.

“Patients responding to valve treatment may now be able to do simple, everyday activities, such as bathe or shower independently, walk around the house without stopping, talk without trouble breathing, and can go out for shopping or entertainment,” said study coauthor Atul C. Mehta, MD, FCCP, Cleveland Clinic Foundation. “Although valve treatment is still investigational, it may offer an alternative treatment for patients with emphysema who are not good candidates for LVRS.” Researchers stress that valve treatment is not yet approved by the US Food and Drug Administration and is only available as part of a research trial that is currently sponsored by the developer of the IBV? Valve, Spiration, Inc.

“Although there is no cure for emphysema, proper treatment can improve a patient’s exercise capacity, overall quality of life, and may result in longer survival,” said Mark J. Rosen, MD, FC
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