2025 Volume 3 Issue 1 Pages 1-11
Lung transplantation and lung volume reduction surgery (LVRS) are considered as treatment options for eligible patients with severe chronic obstructive pulmonary disease (COPD). However, lung transplantation for COPD is constrained by patient age restrictions and donor shortage, while the number of LVRS procedures performed in Japan remains limited because of the high surgical invasiveness and the high rate of postoperative complications. Bronchoscopic lung volume reduction (BLVR) is a less-invasive alternative for reducing the lung volume without needing thoracotomy. BLVR utilizes bronchial valves and involves placing a one-way valve in the bronchus of a hyperinflated emphysematous lobe, consequently reducing the lung volume. These valves block inhalation while permitting exhalation from the peripheral lung bronchus.
In 2018, this treatment method received approval from the U.S. Food and Drug Administration for the treatment of severe emphysema and was covered by health insurance from Japan since December 1, 2023. The success of one-way valve BLVR depends on the careful selection of severe emphysema and hyperinflation patients, who do not have collateral ventilation to the target lobe, and on achieving a complete occlusion of the target bronchus with the valve. Postoperative management is crucial, particularly in preventing complications like pneumothorax. In Japan, BLVR was initially implemented in selected high-volume centers with specialized expertise. The first 140 cases are undergoing post-marketing surveillance to evaluate efficacy and safety. This article provides a review of one-way valve BLVR.
