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Lung valve helps emphysema patient breathe Barbara Hasenzahl of Myrtle Beach is the first patient in the Southeast and eighth in the nation to have a valve implanted in her lung to assist her breathing, which had been severely compromised because of emphysema.  On May 18, MUSC pulmonologist Charlie Strange, M.D., implanted the miniature Emphasys Endobronchial  Valve (EBV) with a bronchosope to isolate the diseased portion of the lung and restore airflow to the healthier portions. The procedure was  part of a nationwide multi-center clinical trial known as VENT (Endobronchial Valve for Emphysema Palliation Trial), involving 20 medical centers across the United States and Europe. Emphysema is a debilitating disease that afflicts more than three million Americans. It is caused primarily by smoking and leads to a progressive, irreversible break-down of lung tissue, reducing the amount available for gas exchange and impairing the lung’s ability to inflate and deflate normally.  As the disease advances, the most damaged areas of the lung overinflate within the chest cavity, trapping air and preventing the healthier lung areas from functioning normally.  Patients with advanced emphysema have difficulty breathing. Advanced emphysema patients become dependent on oxygen support and must carry supplemental oxygen with them wherever they go.  There is no cure for the condition, and for the majority of patients, few available treatment options.  For some patients, lung volume reduction surgery is used to reduce the size of the over-expanded lung, allowing the breathing muscles to function more normally.  “Major surgery poses a number of risks and may even cause life-threatening complications,” said Strange. “The new bronchoscopy procedure avoids surgery and promises to achieve similar results with a significant reduction in risk and complications.”  The procedure  uses a flexible bronchoscope passed through the mouth. It is minimally invasive and involves the implantation of small valves in the patient’s lung to vent out the trapped air in diseased portions of the lung, redirecting inspired air to healthier portions of lung. As a result, the most diseased lung areas shrink, creating more space for the healthier parts to function.  The randomized study will enroll 270 participants across the United States and Europe.  The study will have two arms—the control arm will receive standard optimal medical management, and the treatment arm will receive the valve.  Patients in both arms will undergo pulmonary rehabilitation prior to randomization. The study’s primary efficacy endpoints are improvement in lung function and exercise tolerance. The study also will measure improvement in quality of life and assess cost effectiveness.     Friday, May 28, 2004 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.