Chronic Obstructive Pulmonary Disease

Bronchoscopic Lung Volume Reduction (BLVR)

Appointment New Patient Appointment or 214-645-8300

UT Southwestern Medical Center’s experienced interventional pulmonologists offer bronchoscopic lung volume reduction (BLVR) to help people with severe emphysema, a type of chronic obstructive pulmonary disease (COPD), breathe better.

BLVR is a minimally invasive alternative to traditional lung volume reduction surgery to treat severe emphysema. In BLVR, our interventional pulmonologists place tiny, one-way valves in the airways in the hyperinflated emphysematous sections of the lungs. The valves prevent air from entering the diseased areas but allow trapped air and secretions to escape.

UT Southwestern was the first hospital in Dallas to offer BLVR, and our interventional pulmonologists were involved in clinical studies that led to the development of the procedure.

Benefits of Bronchoscopic Lung Volume Reduction

With emphysema, damaged lung tissue prevents patients from completely exhaling, trapping a significant volume of air in the lungs. As the person continues breathing, the lungs expand, becoming overinflated as they try to take in fresh air to supply the body with oxygen. 

Our interventional pulmonologists can perform BLVR, a minimally invasive procedure that involves no incisions or stitches, to relieve lung hyperinflation. BLVR can help people with severe emphysema that doesn’t improve with other standard treatments, such as medications, pulmonary rehabilitation, and oxygen treatment.

BLVR improves patients’ lung function and quality of life with benefits such as:

  1. Reduced lung volume without removing sections of lung tissue
  2. Expansion of healthy sections of lung, which improves breathing
  3. Less shortness of breath
  4. Increased ability to exercise and do everyday activities
  5. Option of removing airway valves in case of complications
  6. Lower risks of complications without surgery
  7. Faster recovery time

Treatment With Bronchoscopic Lung Volume Reduction

BLVR is best for patients who are taking the maximum medical therapy and doing pulmonary rehabilitation, which is specialized physical therapy for lung conditions. Our specialists thoroughly evaluate patients with severe emphysema to ensure that BLVR is right for them. 

Our evaluation typically includes: 

  • Computed tomography (CT) scan: Specialized X-ray technology that takes cross-sectional images to produce detailed 3D images of the lungs to locate diseased areas
  • Pulmonary function tests: Noninvasive tests to measure airflow in and out of the lungs, how well the lungs move oxygen into the bloodstream, and lung size

The U.S. Food and Drug Administration has approved two valves for implantation with the BLVR procedure to treat emphysema. UT Southwestern offers both valves:

  • Spiration® valve system by Olympus
  • Zephyr® endobronchial valve by Pulmonx

About the Procedure

Our interventional pulmonologists perform BLVR with a bronchoscopy, a minimally invasive procedure. At UT Southwestern, a bronchoscopy for BLVR typically includes the following steps: 

  1. Before the procedure, patients receive either medicines to help them relax or general anesthesia to put them to sleep. They also receive numbing medications in the nostril or mouth and throat to prevent irritation from the scope.
  2. The pulmonologist gently inserts the bronchoscope through either a nostril, the mouth, or endotracheal anesthesia tube. This narrow, flexible scope is a tube that has a camera at the tip to allow the doctor to see inside the airways and lungs.
  3. The doctor uses the bronchoscope to study lung ventilation and place tiny valves into the airways leading to the hyperexpanded sections of the lungs. 
  4. At the end of the procedure, the pulmonologist removes the scope.

Once implanted, the one-way valves reduce lung volume by preventing airflow into the diseased areas and allowing trapped air and secretions to escape. With BLVR, the valves direct air to healthier sections of the lung, allowing those sections to function more normally.

After the procedure, patients typically stay in the hospital for two to three days before being discharged. By comparison, traditional lung volume reduction surgery generally has longer recovery time.  

Clinical Trials

In addition to scientific work and a large body of literature over the past two decades, two landmark clinical studies led to FDA approval of the valves and the BLVR procedure to implant them. 

  • The LIBERATE study evaluated the Zephyr® endobronchial valve made by Pulmonx
  • The EMPROVE study evaluated the Spiration® valve system. UT Southwestern pulmonologists were involved in the EMPROVE study, led by Muhanned Abu-Hijleh, M.D. 

UT Southwestern’s pulmonologists participate in ongoing research and clinical studies of new technologies to improve treatment for a wide variety of lung conditions, including additional types of BLVR. Ask about current trials we are involved in for BLVR.