Emphysema Treatment and Management, Including BLVR

Emphysema is an advanced form of chronic obstructive pulmonary disease (COPD). Doctors estimate that more than 24 million people in the United States have emphysema or another form of COPD.

This progressive, debilitating disease, is characterized by irreversible destruction of air sacs (alveoli) in the lungs, which decreases air flow. This progressive destruction makes it difficult to breathe, making even simple daily activities a challenge.

The most common symptom of emphysema is a chronic cough. Additional symptoms can include:

• Shortness of breath
• Frequent lung infections
• Reduced appetite and weight loss
• Fatigue

The most common cause of emphysema is cigarette smoking. Quitting smoking can help prevent you from getting the disease. If you already have emphysema, not smoking might keep it from getting worse.

Progression — The Difference Between Mild and Severe Emphysema

Patients with mild emphysema may experience symptoms such as shortness of breath, wheezing, and persistent cough. These symptoms are usually managed with prescription inhalers and lifestyle modification. As emphysema progresses to more severe stages, your symptoms become more profound and may result in flare-ups that lead to hospitalization.

Emphysema Treatment

While COPD and emphysema are not curable, there are treatments that can help you manage the disease. Treatment for emphysema varies based on your symptoms. Mild emphysema can be managed with prescription inhalers, oxygen and pulmonary rehabilitation.

As the disease progresses, oxygen therapy and pulmonary rehabilitation may be prescribed for severe emphysema. Once medical therapy achieves maximum benefit, the remaining options for treatment have been limited to surgical lung volume reduction or lung transplantation, until recently.

Bronchoscopic Lung Volume Reduction (BLVR) for Emphysema

BLVR, which uses small endobronchial valves, is a new, minimally invasive treatment option that has shown to greatly improve quality of life for patients with severe emphysema. Patients with emphysema who are still short of breath despite using their inhalers should be evaluated for valves. Not everyone who is evaluated will qualify. In order to qualify, you must meet certain criteria that are assessed with a CT scan, ultrasound of your heart (echocardiogram), and breathing tests.

Patients who have undergone this procedure experience benefits, including:

• Ability to walk longer distances
• Increased energy
• Increased lung function
• Less shortness of breath
• Return to activities that were limited previously

BLVR is only available at select centers across the United States, including Froedtert Hospital.

If you have severe emphysema and are still short of breath despite using your inhalers, you should be evaluated for valves. 

How BLVR Works

During this minimally invasive procedure, a physician places tiny valves in the airways to block diseased parts of the lungs to reduce hyperinflation. This 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 whole procedure, which generally takes 30 to 60 minutes.

After valve placement, you will stay in the hospital for 3 days to monitor for complications. You will be back on your feet walking the hallways the day after the procedure. If any complications occur, you may need to stay in the hospital longer.

Some patients notice a difference in their breathing before leaving the hospital, but it is more common to notice improvement 2 to 6 weeks after the procedure.

If you would like to talk with our care team to determine if you may be a candidate for BLVR, call 414-777-7700. If you are a physician with a patient who may be a candidate for BLVR or you would like more information, please call 414-805-4700.