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BookmarkApril 1, 2006 — By implanting a valve through the bronchia, surgeons can now prevent air from getting trapped in emphysema-stricken lungs. The valve deflates the diseased parts of the lung, making space for healthy lung tissue to work. The procedure, not yet approved by the FDA, is a non-surgical and less-risky than traditional therapies such as lung-reduction surgery.
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BALTIMORE--Breathing seems easy, but it's not if you have emphysema -- shortness of breath becomes a way of life. Now, patients with emphysema are breathing better thanks to a new way to fight this deadly lung disease.
Martine Cantler has emphysema. It makes breathing hard and doing simple household chores even harder. "Carrying things up and down the stairs had become almost impossible to do," Cantler says.
Emphysema causes air to get trapped in the lungs and blow up like a balloon, hogging space for healthy lung tissue to work. Thanks to a new therapy called an endo-bronchial valve procedure breathing is no longer a problem for Cantler. "I can carry a huge bag of laundry upstairs."
Mark Krasna, a thoracic surgeon at the University of Maryland Medical Center in Baltimore, says, "It's going to make the patient breath easier because it helps the mechanics of their breathing when they breathe and expand and contract."
Thoracic surgeons place the tiny valve inside the lungs using a broncho-scope. Exhaling opens the valve, releasing trapped air, and inhaling prevents its return. The valve deflates the diseased parts of the lung, making space for healthy lung tissue to work.
"I think this is going to be a really revolutionary therapy for patients with emphysema," Dr. Krasna says.
The valve procedure is a non-surgical, less-risky treatment for emphysema than traditional therapies like lung-reduction surgery. It has not yet been FDA approved.
BACKGROUND: Doctors at the University of Maryland Medical Center are testing a new approach to treat advanced emphysema, a common lung disease. They have implanted a miniature one-way valve in the lungs of a patient with emphysema as part of a 20-center-randomized study of 270 patients to see if the valves improve lung function and exercise tolerance. Known as an endobronchial valve procedure, the therapy is minimally invasive and does not involve surgery to remove part of the diseased lung.
HOW IT WORKS: In patients with emphysema, inhaled air becomes trapped in the diseased portion of the lung, making it difficult to exhale. The trapped air fills the lung like a balloon, constricting the healthy lung tissue. The one-way valves release trapped air and prevent its return by causing the diseased portion of the lung to deflate, called lung volume reduction. This creates space for healthy tissue to function normally. The valves are implanted with a bronchoscope, a thin tube equipped with a camera that allows physicians to look inside the lungs. The valves are about the size of a pencil eraser and have tiny metal tongs or tines that attach to the lung.
ABOUT EMPHYSEMA: Emphysema is a lung disease in which the walls of the air sacs in the lungs fracture or burst. Those that remain enlarge to make up for the loss. Most commonly caused by cigarette smoke, the disease leads to a progressive, irreversible breakdown of lung tissue, in which the air sacs are badly damaged. This reduces the elasticity of the lungs, impairs their ability to inflate and deflate normally, and reduces the transfer of oxygen to the blood, so that patients constantly feel out of breath.
