Endobronchial Valve (EBV) Therapy

What Is Endobronchial Valve (EBV) Therapy?

If you have been diagnosed with advanced COPD and emphysema, EBV treatment might be an option for you. Patients living with COPD experience shortness of breath because areas within the lungs are diseased and are holding trapped air (hyperinflation of the lung). This makes it difficult to inhale and fill the lungs with new air. There is no cure for COPD or emphysema, but EBVs can improve your lung function and quality of life.

EBVs are removable, one-way valves that reduce lung hyperinflation by allowing the trapped air to escape. As a result, lung function may improve when healthier areas of the lungs provide the necessary oxygen exchange. They are a safe, effective and approved treatment for eligible patients with research-based evidence that supports this treatment for individuals who may qualify. There are two types of valves that have been FDA-approved since 2018 in the United States:

1. Zephyr Valve by Pulmonx.
2. Spiration Valve by Olympus.

What to Expect During the Procedure?

• Your procedure will begin with you being given medication to fall asleep.
• Your healthcare provider will use a bronchoscope, which is a small tube with a camera attached, that will go through your nose or mouth and down to the affected airways in your lungs.
• The camera will guide placement of an average of four valves in a targeted, diseased lobe of your lungs.
• The entire procedure takes about 60 minutes and then you will wake up.
• Recovery time is shorter after EBV treatment compared to open surgery, but you will still need time to rest and recover. Expect to stay in the hospital for 2-3 nights following your procedure. Once home, most patients will regain most of their strength and energy after two – three weeks, and with the treatment goal of experiencing less shortness of breath when resuming normal activities.

What Are the Benefits and Risks?

The treatment goal of EBVs is for you to breathe easier and feel better. This looks a bit different for everyone, but in general, your healthcare provider will be monitoring you for these anticipated outcomes:

• You experience an improvement in your breathing, measured by your lung function.
• You can increase your activity and exercise levels.
• You feel you have an improved quality of life.
• You may live longer, and in better overall health.

EBVs are placed during a minimally invasive procedure that does not require any cutting or incisions. Like all medical procedures, there are risks. They include infection, bleeding, pneumothorax and pain. However, there are many benefits to EBV treatment compared to lung volume reduction or lung transplant surgery, and depending on your situation you may experience:

• Faster recovery and return to normal activities
• Fewer complications
• Shorter hospital stays
• Less pain and decreased need for pain medications
• Smaller scars
• Less blood loss
• No cutting of the ribs or breastbone

Each person handles medical procedures a little differently and your outcomes may depend on several factors, such as your health history, the severity of your COPD and/or your surgeon’s experience.

Who Is Eligible?

You must be at least 22 years old to be eligible, and there is no upper age limit. Individuals may qualify for EBV treatment if they have advanced emphysema or severe COPD and are highly symptomatic despite receiving optimal medical treatment. Examples include smoking cessation, guidelines-based pharmacological therapy (medicines), pulmonary rehabilitation, nutrition support, supplemental oxygen therapy and noninvasive ventilation. 

Steps to follow if you believe you may be eligible for this treatment:

1. Speak with your healthcare provider. Depending on if you see a primary care provider or pulmonologist to treat your COPD, there may be limited knowledge about this treatment option. Getting a referral to a provider who is experienced with EBV can help get your questions answered.
2. Get a referral. Only specially trained healthcare providers provide this treatment and you’ll need to work with your healthcare provider to get a referral. If you aren’t sure how to proceed, you can call our Lung HelpLine at (800-LUNG-USA) and our team can help you get started.
3. Get tested. Your healthcare provider determines if you are a good candidate for this therapy based off the results of a pulmonary function test, CT scan, ABG blood test and six-minute walk test. Other tests may be required, depending on the results of initial tests.
4. Quit smoking. An individual needs to be non-smoking, or willing to quit, to receive this treatment. The Lung Association offers Freedom From Smoking to assist tobacco users who are ready to quit.
5. Follow up with your insurance. Most patients secure insurance coverage for this treatment but it is always a good practice to check and make sure you go in knowing what your out-of-pocket expenses will be.