Emphysema is a form of chronic obstructive pulmonary disease (COPD) that is characterized by destruction of lung tissue and formation of blebs, which results in impaired gas exchange and abnormal increase in the amount of lung volume trapped in the chest. Also known as hyperinflation, this excessive degree of air build up places respiratory muscles at a mechanical disadvantage leading to progressive shortness of breath. Lung volume reduction procedure aims to stop the vicious cycle of breathlessness caused by hyperinflation.
Bronchoscopic or endobronchial volume reduction is a novel FDA approved procedure for selected patients with severe emphysema and hyperinflation. Procedure involves insertion of one way valves into most disease affected lobe, thereby allowing air to exit but not re-enter. This leads to volume reduction in the treated portion of the lung, improvement in symptoms and an increase in pulmonary function. Patients are able to walk further, perform more activities of daily living and some are even able to get off oxygen.
Unlike surgical lung volume reduction, endobronchial valves are performed exclusively through a bronchoscope (flexible fiberoptic camera) without any need for surgical intervention, stitches or scars. This offers additional treatment options for patients with compromised respiratory status who are unfit for surgery. Patients who are candidates for lung volume reduction but cannot undergo endobronchial valve placement are offered surgical lung volume reduction procedure using minimally invasive surgical techniques.
Dr Eugene Shostak is a board certified interventional pulmonologist with expertise in lung volume reduction procedure. He was involved in some of earlier lung volume reduction trials and performs a high number of endobronchial lung volume reduction procedures in New York City. Our valve program at Weill Cornell Medicine is one of the busiest, if not the busiest, programs in NYC.
Dr Eugene Shostak closely collaborates with thoracic surgeons at Weill Cornell Medicine to develop a personalized treatment approach for each patient.
There are several elements that set our lung volume reduction program apart from others. There are two approved companies that make valves and here at New York Presbyterian | Weill Cornell Medicine we use both the Spiration and Zephyr endobronchial valves. Having flexibility to chose allows Dr Shostak to tailor the therapy to individual patient’s anatomy and produce great results. Our surgical lung volume reduction procedures are usually performed via minimal invasive approach and are often limited to only one side, thereby targeting the most severely affected portion of the lung without the need to do both sides as is often described in the traditional surgical lung volume reduction operation.
In several large clinical trials, patients treated with endobronchial lung volume reduction enjoyed improvement in lung function and quality of life compared with control group.
Contact us at 212-746-5166 to find out if bronchoscopic lung volume reduction is a right procedure for you.