Intrabronchial valve treatment in patients with severe heterogeneous emphysema and intact interlobar fissures

Background: The success of intrabronchial valve treatment (IBV) for emphysema depends on appropriate patient selection. Methods: Single-center, prospective study of patients with severe, symptomatic emphysema despite optimal medical treatment. Only patients with evidence of a target lobe with ≥ 40% emphysema destruction, ≥ 15% point difference compared with the ipsilateral lobe, and ≥ 90% complete interlobar fissures were considered eligible. Computed lung tomography, lung function, and symptoms were recorded at baseline and at 3 months post valve treatment. Results: 144 patients with moderate-to-severe COPD underwent eligibility assessment. Out of these, 23 (17% of total) fulfilled the radiological criteria for valve treatment. Data on 19 patients with full data available at 3 months post valve treatment are presented. Patients treated had a mean±SD age of 65±7 yrs, FEV1 26±6% predicted, Residual Volume 307±67%, and a baseline SGRQ of 57±17. 15 out of 19 patients received lower lobe treatment. There were statistically significant improvements in FEV1 (+90±117ml), residual volume (- 540±750ml), and SGRQ (-7.2±13.7) at 3 months post valve treatment (p Conclusions: Intrabronchial lobar valve treatment in patients with heterogeneous emphysema and complete interlobar fissures is associated with favourable clinical outcomes with acceptable safety.