How Valve Treatments Work for COPD

Here’s everything you need to know about valve treatments, how they work, the risks and benefits, and more.

When you live with chronic obstructive pulmonary disease (COPD) or emphysema, you may wonder what treatment options are right for you. Endobronchial valve (EBV) therapy is a recent innovation that may offer some relief to help you breathe more easily.

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What is valve treatment for COPD?

When you have COPD, your lungs lose elasticity, allowing you to hold in too much air. This can make it difficult to breathe in and out with less oxygen.

According to the American Lung Association (ALA), valves work by encouraging your lungs to breathe out retained air and breathe in the fresh oxygen your body needs.

EBVs are a series of one-way, removable devices inserted into your airway. On average, three or four valves are placed during a procedure. They’re placed in the airways that lead to the most damaged areas of your lungs.

The valves control the airflow to your lungs. As you breathe in, the valves close so that air can’t enter the damaged part of your lungs. As you breathe out, the valves open to allow the trapped air to escape.

The Food and Drug Administration (FDA) has approved two types of valve treatment that are currently on the market: Zephyr and Spiration. The Zephyr valve was approved in 2018 to improve lung functioning, ease of breathing, and quality of life. According to a 2022 research review, the Spiration valve provides the same value and benefits.

Until recently, lung transplantation and lung reduction surgeries were the two surgical methods available to help people living with COPD. Valve treatments now offer a new option. According to a 2018 study, valves have fewer complications, reduce hospital stays, and offer a faster recovery time for people living with advanced COPD.

What happens during the procedure?

The valve placement procedure will take place in a hospital. It’s minimally invasive, meaning there are no surgical incisions, and you’ll be sedated so that you won’t feel anything. The valves are small — about the size of a pencil eraser.

According to the ALA, here are important facts to know:

• The doctor will give you intravenous (IV) sedation and then perform the procedure once you become drowsy.
• The valves are placed during a bronchoscopy, which takes about an hour. Your doctor will place a bronchoscope (a small tube with a camera attached) in your nose or mouth to see inside your airway so they can place the valves in the best position.
• Your care team will monitor you in the recovery room while you wake up from the procedure and for a few days afterward. You may have to stay in the hospital for 2 or 3 nights so they can monitor you for complications.

What happens after the procedure?

After the procedure, you may feel worn out and more tired than usual. Here are some things to keep in mind:

• It usually takes 2 to 3 weeks to regain your energy and return to your daily activities.
• It’s important to pay attention to your physical and emotional self-care needs as you recover.
• After the valves are placed, you’ll continue taking your COPD medications. Your doctor may also temporarily prescribe antibiotics or steroids if necessary.
• A few weeks after you’re discharged from the hospital, you’ll see your doctor for follow-up care and to discuss any medication changes.

What are the risks and benefits of valve therapy?

As with other medical procedures, there are risks and benefits to EBV therapy. The risks are primarily associated with your overall health and other medical conditions.

The most common risks related to this procedure, according to the ALA, are:

• pneumothorax (an air leak in your lungs)
• pneumonia (an infection in your lungs)
• bleeding in your lungs
• pain in your chest or throat
• worsening emphysema

If you experience any complications, your doctor may keep you in the hospital for a couple of extra days while they decide when you’re ready to go home.

Valve treatment is considered an alternative treatment to control advanced COPD or emphysema. There are multiple benefits to having the procedure, including:

• increased lung function
• ease of breathing
• improved quality of life

A clinical trial from 2021 showed an improved quality of life for 1 year after valve placement. As your breathing improves, you might notice improvements in your health.

Who can get a valve procedure?

Valve therapy is for people with advanced COPD or emphysema who still feel short of breath despite medication. Your doctor might refer you to a pulmonologist who performs valve placement therapy. This specialist can help guide your decision and answer your questions.

The following tests can help your doctor determine whether you can have this treatment:

• pulmonary function test
• CT scan
• ABG blood test
• 6-minute walk test

The procedure isn’t right for you if you smoke; have an allergy to nickel, titanium, nitinol, or silicone; or have an active infection such as pneumonia or the flu. Additionally, you won’t be able to have this treatment if you’re unable to have a bronchoscopy or if you’ve had a lung transplant or a major lung procedure.

Takeaway

COPD causes air to become trapped in your lungs, leading to less oxygen intake and more difficulty breathing. Valve placement therapy may offer a solution if you have advanced stages of COPD or emphysema and are seeking new treatment options. The procedure is minimally invasive and could help improve your lung function and make breathing easier.