A 79-year-old retiree with chronic emphysema, who had trouble breathing at rest, underwent a new life-altering procedure at South Miami Hospital which involves implanting an “endobronchial valve” in the diseased area of his lungs.
It was the first time this minimally invasive procedure, made possible by a recent approval by the U.S. Food and Drug Administration (FDA), was performed in Miami-Dade County.
An endobronchial valve is a device that permits one-way air movement. During inhalation, the valve is closed to prevent air flow into the diseased area of the lung. The valve opens during exhalation to allow air to escape from the diseased area.
“He (the patient) was maximized on medical therapy (medications and rehabilitation) and was suffering from depression and anxiety because he had trouble breathing at rest,” explains Michael Hernandez, M.D. , a pulmonologist affiliated with the Lung Health Program  at South Miami Hospital. “He often stated that ‘I cannot go on living like this.’ He was more persistent than any patient I have met to get this procedure done once he realized this was an option.”
The patient is doing well and did not suffer any complications. He was up and walking around the Intensive Care Unit hours after the procedure, said Dr. Hernandez. He had suffered from hyperinflated lungs, which is when air gets trapped in the lungs and causes them to overinflate. This hyperinflation is experienced by people with chronic obstructive pulmonary disease (COPD) — a disorder that includes emphysema.
The procedure results in “lung volume reduction of the diseased lung,” says Dr. Hernandez. The previous alternative for these critical patients was very risky surgery that carried up to a 60 percent complication rate over three months, he said.
In June 2018, the FDA approved Zephyr endobronchial valves, manufactured by Pulmonx , as the first bronchoscopic treatment for emphysema in the U.S. for patients with hyperinflation.
“What these valves do is let air out of the target (diseased) lobe of the lung and not let air back in,” says Dr. Hernandez. “It’s basically a one way valve that causes that lobe to collapse. Once the diseased lobe collapses, the healthy lung is allowed to expand. This allows the diaphragm to rise into a more natural position. As a result of this, patients have improved lung function, and better quality of life.”