Bronchoscopic Lung Volume Reduction (BLVR)

COPD is a chronic lung disease which leads to shortness of breath. Patients with COPD can have ‘Emphysema’ which is characterized by destruction of lung tissue or ‘Chronic bronchitis’ which is characterized by excessive mucus production. Patients can also have both variants at the same time. Those with emphysema can have excess air that gets trapped in their lungs leading to hyperinflation. This makes it harder to take full breaths because of an inability to fully exhale air before another breath is taken. 

Bronchoscopic lung volume reduction (BLVR) is a new, minimally invasive treatment option that has been shown to greatly improve quality of life for patients with severe emphysema. BLVR is only available at select centers in the US, including the University of Tennessee Medical Center. Our Interventional Pulmonology team places FDA approved endobronchial valves in the airways. Numerous studies have proven these valves to be a safe and effective treatment for patients with severe emphysema.

BLVR has been shown to improve the shortness of breath related to COPD with Emphysema. Patients who undergo this procedure experience benefits such as: 

• Ability to walk longer distances 
• Improved lung function 
• Less Shortness of Breath 
• Return to activities that were limited previously 

As with any procedure, please speak with your doctor as there are risks and individual results can vary. Some patients may experience complications such as Lung collapse (pneumothorax), Flare-ups of COPD, Cough, Pneumonia, Lung abscess and Hemoptysis (coughing up blood) 

BLVR is indicated for patients with refractory shortness of breath due to COPD with emphysema; despite optimization of inhaled therapies and a trial of pulmonary rehabilitation. It will not be performed on current smokers.

BLVR is not a medication or surgery that requires an incision. During this minimally invasive procedure, a physician uses a thin flexible camera to place tiny valves in the airways of a pre-planned portion of the lung. The aim is to reduce lung volume and therefore hyperinflation in patients with severe emphysema. By placing the valves in selected airways, it helps the healthier parts of the lungs to expand and lifts pressure off the diaphragm, decreasing shortness of breath and making breathing easier.  

• Patients are under general anesthesia for the procedure, which takes about 30-60 minutes.  
• A small bronchoscope (a long flexible tube with a camera at the end) is inserted through your mouth into your airways. Prior to insertion of valves, an assessment is performed to check the level of leak in between different chambers of lung.  
• Small one-way valves are placed into the airway branches within the pre-selected portion of the lungs. This reduces or stops the air flowing into the targeted port of the lung but allows the air or fluid to escape during exhalation. 
• The number of valves inserted can vary from patient to patient. Typically, three to five valves are used during a procedure 

• After the placement of endobronchial valves, patients will have a standard three-to-five-night hospital stay for observation. This allows for careful monitoring with daily chest X-rays to ensure the valves are working properly and there are no immediate complications such as lung collapse (pneumothorax)  
• Daily Chest Xray may show reduction in lung volume during the hospital stay. Sometimes this effect is delayed. After discharge, patients are followed in clinic at routine intervals with additional testing to ensure proper response to the procedure. 

Your doctor will determine if this procedure is right for you based on your pre-existing conditions, the location of diseased lung tissue, their overall health, and their smoking status. The procedure is not indicated for patients with: 

• Chronic bronchitis 
• Asthma 
• People with recurrent lung infections 
• People who have had prior lung volume reduction surgery 
• People with lung cancer 

If you would like to set up an evaluation with our Interventional Pulmonology team to determine if you are a candidate for BLVR, please call 865-305-3926.