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Free Paper Presentation ; Efficacy of Bronchoscopic Lung Volume Reduction by Endobronchial Valves in Patients with Heterogeneous Emphysema: Report on the First Korean Cases
박태선 , 이재승 , 오연목 , 이상도 , 이세원
UCI I410-ECN-0102-2014-500-002060737
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Purpose: Bronchoscopic lung volume reduction (BLVR) is a new treatment for emphysema, with proven efficacy. Although a lot of patients have taken benefit from this procedure worldwide, experience of BLVR in Asian emphysema patients is scarce. Methods: Since the first Korean patients undertook this procedure in July 2012, a total of 7 patients with advanced emphysema undertook BLVR in Asan Medical Center until March 2013. They had severe dyspnea and poor lung function (Modified Medical Research Council dyspnea scale 3-4; median forced expiratory volume in 1s [FEV1], 0.59 L [19.0% predicted]; median 6-min walk distance [6MWD], 195 m). Endobronchial valves were inserted into target bronchi after verifying complete fissure of target lobe on computed tomography and confirming that target lobe had no collateral ventilation with other lobes using Chartisⓡ Pulmonary Assessment System. Results: Six patients showed clinical improvement. Of them, two patients improved to dyspnea scale 1; four patients to 2 (p=0.026). The median FEV1 increased from 0.59 L to 0.89 L (by 51%; p=0.028) and the median 6MWD increased from 195 m to 252 m (by 29.2%; p=0.028). Two patients developed a pneumothorax (one requiring drainage) and one patient experienced slight hemoptysis. However, there were no other important adverse events. Conclusions: BLVR proceeded well in Korea and it showed benefits in symptoms, lung function and exercise capacity in Korean patients with advanced emphysema. Optimizing subject selection might increase efficacy and safety of BLVR. Purpose: Bronchoscopic lung volume reduction (BLVR) is a new treatment for emphysema, with proven efficacy. Although a lot of patients have taken benefit from this procedure worldwide, experience of BLVR in Asian emphysema patients is scarce. Methods: Since the first Korean patients undertook this procedure in July 2012, a total of 7 patients with advanced emphysema undertook BLVR in Asan Medical Center until March 2013. They had severe dyspnea and poor lung function (Modified Medical Research Council dyspnea scale 3-4; median forced expiratory volume in 1s [FEV1], 0.59 L [19.0% predicted]; median 6-min walk distance [6MWD], 195 m). Endobronchial valves were inserted into target bronchi after verifying complete fissure of target lobe on computed tomography and confirming that target lobe had no collateral ventilation with other lobes using Chartisⓡ Pulmonary Assessment System. Results: Six patients showed clinical improvement. Of them, two patients improved to dyspnea scale 1; four patients to 2 (p=0.026). The median FEV1 increased from 0.59 L to 0.89 L (by 51%; p=0.028) and the median 6MWD increased from 195 m to 252 m (by 29.2%; p=0.028). Two patients developed a pneumothorax (one requiring drainage) and one patient experienced slight hemoptysis. However, there were no other important adverse events. Conclusions: BLVR proceeded well in Korea and it showed benefits in symptoms, lung function and exercise capacity in Korean patients with advanced emphysema. Optimizing subject selection might increase efficacy and safety of BLVR.

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