Breathe Easier! Lung Valve Surgery Relieves COPD Symptoms

A jolt of caffeine is all Chester Pine, Sr. thought it would take.

A former long-time smoker with emphysema and severe chronic obstructive pulmonary disease (COPD), Chester would drink coffee if he began to feel short of breath. While Chester’s reasoning wasn’t far off—coffee does contain a small amount of a chemical used in drugs to open your airways—it wasn’t a long-term solution.

This spring, Chester, 78, was the first person to undergo a bronchoscopic lung volume reduction (BLVR) procedure at Virtua Marlton Hospital. During this minimally invasive procedure, tiny valves are implanted in the airways of the lungs. The valves allow the healthier portion of the lungs to inflate, resulting in easier breathing and an improved quality of life.

“Previously, lung volume reduction was performed by a thoracic surgeon, who through a long incision in the chest would remove the diseased portion of the lung,” said Virtua pulmonologist Syed Riaz, MD, who performed the BLVR. “Now, we are achieving the same result nonsurgically.”

A Heavy Smoker
Chester began smoking when he was 8 or 9 years old, a time when cigarettes were the epitome of cool and glamour. A construction machine operator, he often smoked three or four packs a day.

Over time, breathing became more difficult. Then one night, Chester was having such trouble breathing he turned blue.

“I drank two pots of coffee. I still couldn’t breathe,” he said.

Chester’s daughter rushed him to the emergency room.

Following doctors’ advice, Chester quit smoking. But his lungs were so damaged that over time, he could no longer walk more than 50 feet without having to stop and catch his breath. He required oxygen at night and whenever he went out.

“He’d come into the office, and after the third or fourth breath as I listened to his lungs during his physical exam, he would suddenly become short of breath,” said Chester’s pulmonologist, Emilio Mazza, MD, PhD, medical director of the Intensive Care Unit at Virtua Mount Holly Hospital. “He’d have to stop to catch his breath. He would be hyperinflating before my eyes, the air trapped in his lungs.”

Improved Breathing
This spring, Dr. Mazza told Chester about the new BLVR procedure and sent CT scans of his lungs to see whether he qualified. Deemed a suitable candidate, Chester first completed pulmonary rehabilitation to improve his strength and stamina.

During the April 19 procedure, a thin, lighted tube called a bronchoscope was threaded into his lungs. Dr. Riaz inserted three small endobronchial valves into a diseased portion of his lower right lung.

The umbrella-shaped valves collapse the most diseased portions of the lungs so the relatively healthier parts can inflate and occupy most of the space in the chest cavity, making it easier to breathe. Pulmonologists can place valves in the upper and lower portions of the lung.

“When a person’s lungs are hyperinflated and air is trapped, there is pressure on the diaphragm. Normally, the diaphragm is dome-shaped. It contracts and flattens when you inhale, and returns to its natural shape when you exhale. When the lungs are hyperinflated, the diaphragm remains flat, making it difficult to breathe,” said Dr. Riaz. “With this procedure, not only are we improving air flow, we are restoring the proper mechanics of breathing.”

Like a Spring Chicken
Since the procedure, Chester said he “feels like a spring chicken” and can walk outside his Cookstown, Burlington County home without oxygen.

“While BLVR is not a cure for COPD, we can greatly improve a patient’s quality of life,” said Dr. Riaz. “We are pleased to offer this procedure at Virtua.”

Comprehensive Lung Care
Virtua pulmonary medicine specialists use the latest tools to diagnose and treat your breathing problems. Schedule an appointment with a Virtua pulmonologist now.

Updated September 22, 2021

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