Sequential Bilateral Bronchoscopic Lung Volume Reduction With One-Way Valves for Heterogeneous Emphysema

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Respiratory Medicine

Background:

• Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) shows clinical benefits for heterogeneous emphysema.
• Unilateral EBV treatment has demonstrated efficacy, but the potential for contralateral treatment to prolong benefits is less understood.

Purpose of the Study:

• To assess the viability, effectiveness, and safety of sequential bilateral EBV procedures.
• To evaluate if a bilateral approach can prolong the clinical benefits of BLVR in patients with heterogeneous emphysema.

Main Methods:

• Retrospective multicenter study of consecutive patients with heterogeneous emphysema undergoing EBV deployment.
• Patients were categorized into unilateral and sequential bilateral procedure groups.
• Intergroup differences were analyzed to compare outcomes.

Main Results:

• 14 out of 49 patients (28%) underwent sequential bilateral procedures due to loss of initial benefits.
• The second procedure significantly improved FEV1, FVC, RV, 6MWT, and SGRQ scores.
• No significant differences in functional improvements were observed between unilateral and bilateral groups.

Conclusions:

• Sequential bilateral BLVR using EBVs is a viable strategy for patients with bilateral heterogeneous emphysema.
• This approach can restore and prolong respiratory function improvements when benefits from the first procedure wane.