Efficacy of bronchoscopic lung volume reduction by endobronchial valves in patients with heterogeneous emphysema: report on the first Asian cases

J Korean Med Sci. 2014 Oct;29(10):1404-10. doi: 10.3346/jkms.2014.29.10.1404. Epub 2014 Oct 8.

Abstract

Although many patients with severe emphysema have benefited from bronchoscopic lung volume reduction (BLVR) worldwide, experience of BLVR in Asian emphysema patients is scarce. Between July 2012 and March 2013, seven patients with advanced heterogeneous emphysema underwent BLVR in the Asan Medical Center. They had severe dyspnea and poor lung function (Modified Medical Research Council dyspnea scale 3-4; median forced expiratory volume in 1 sec [FEV1], 0.59 L [19.0 % predicted]; median 6-min walk distance [6MWD], 195 m). Endobronchial valves were inserted into the target lobe which was most hyperinflated and least perfused, and had no collateral ventilation with other lobes. Six patients showed clinical improvement after 1 month. Of them, 2 patients improved to dyspnea scale 1 and 4 patients did to scale 2 (P = 0.026). The median FEV1 increased from 0.59 to 0.89 L (51%; P = 0.028) and the median 6MWD increased from 195 to 252 m (29.2%; P = 0.028). Two patients developed a pneumothorax (one requiring drainage) and one patient experienced slight hemoptysis; however, there were no other serious adverse events. BLVR is effective in Asian advanced emphysema patients, with noted clinical improvements in lung function and exercise capacity.

Keywords: Emphysema; Individualized Medicine; Lung Volume Reduction; Patient Selection; Pulmonary Disease, Chronic Obstructive.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asian Continental Ancestry Group
  • Bronchoscopy / methods*
  • Forced Expiratory Volume
  • Humans
  • Lung / pathology
  • Lung / surgery
  • Male
  • Middle Aged
  • Pneumonectomy / methods*
  • Pulmonary Emphysema / surgery*
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Treatment Outcome