Endobronchial Valve Placement in Selected Patients with Severe Emphysema

Endobronchial valve (EBV) placement via bronchoscopy might offer a less invasive way than surgery to achieve lung-volume reduction in patients with severe emphysema (NEJM JW Gen Med Nov 15 2010 and N Engl J Med 2010; 363:1233). EBVs are one-way valves that allow air to leave, but not enter, a lung segment; in reducing the volume of poorly functioning emphysematous lung, EBVs presumably improve lung mechanics and reduce ventilation-perfusion mismatching. Investigators enrolled 68 patients with severe emphysema (average forced expiratory volume in 1 second [FEV₁], 29%), computed tomographic evidence of complete or nearly complete fissures between target and adjacent lobes, and no evidence of collateral ventilation on bronchoscopic evaluation.…