Overview
Bronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure for patients with severe emphysema. This means BLVR involves no incisions or stitches. The bronchoscopic lung volume reduction has many benefits, such as a shorter recovery time and the ability to be reversed in the case of complications. The goal of the BLVR is to improve lung function for patients with emphysema.
Lung volume reduction is done primarily through surgery or by bronchoscopically placing one-way valves in the airways. During expiration, the one-way valve allows mucus to exit. During inspiration the one-way valve prevents air from entering, gradually leading to lung volume reduction.
Valve therapy is not for all emphysema patients. Strict adherence to clinical selection guidelines is necessary for optimal results. Patients will have a thorough evaluation to determine candidacy.
Parkview offers the Olympus spiration value therapy system, one of two systems approved in the United States.
Testing guidelines and criteria
Bronchoscopic lung volume reduction (BLVR) may be considered for patients with emphysema if they fulfill the following criteria:
- 18 years of age with severe emphysema (GOLD III or IV).
- Patient has a BMI > 15 and < 35 kg/m2
- FEV1 ≤45% predicted and > 15% predicted.
- DLCO: > 20% predicted.
- Residual Volume (RV) ≥ 150% predicted.
- Total Lung Capacity (TLC) ≥ 100% predicted.
The procedure may not be a good choice if patients have-
- Patient has giant bullae considered to be > 1/3 volume in either lung.
- Is a candidate for lung transplantation.
- An active smoker with no interest in quitting.
- BMI <15 or >35 kg/m2.
- Patient has severe pulmonary hypertension (RVSP pressure > 50 mmHg).