Review of the Zephyr Valve Treatment: Its uses, benefits, and risks

A Zephyr Endobronchial Valve System, or Zephyr Valve, is a device used by doctors to treat severe instances of COPD and emphysema. By improving airflow to the healthy parts of the lungs, they may enhance a person’s quality of life and breathing.

This page goes into greater information about the Zephyr Valve treatment, including the operation, who it is appropriate for, and the risks and benefits. It also goes through what to expect following the operation and other options for people who aren’t a good fit for the procedure.

What is a Zephyr Valve?

Zephyr Valve

Zephyr Valves, according to the COPD Foundation, are minimally invasive devices that can help people with severe emphysema breathe easier. Their use was approved by the Food and Drug Administration (FDA) in 2018.

Air flows via the pharynx and larynx and into the lungs when a person breathes. Individuals with severe emphysema, on the other hand, develop hyperinflation, which occurs when air becomes trapped in the lungs. This causes shortness of breath by preventing new air from entering the lungs.

The damaged parts of the lungs that contribute to hyperinflation can be blocked off with a Zephyr Valve. It functions similarly to a train system.

When a person breaths out, it reroutes airflow to the healthy parts of the lungs and allows trapped air and fluids to leave. This relieves pressure on the diaphragm and enhances breathing for the individual.

Furthermore, this device permits the healthy parts of the lungs to expand and grow, making it easier for people to exercise and engage in other daily activities.

Individuals who receive a Zephyr Valve will have a quick installation procedure with no cuts or incisions. As a result, they can be used as an alternative to more intrusive treatments like lung transplants.

How to use

The Zephyr Valve treatment is a one-time, in-patient procedure in which the valves are inserted into the airways by a specialist during a bronchoscopy.

A doctor will recommend a patient to a lung specialist if they believe they are a candidate for Zephyr Valves. The doctor will then conduct lung function tests to see if the treatment is appropriate for the patient.

During the procedure

A surgeon will perform the following procedures during a Zephyr Valve procedure:

  • give the patient a sleeping pill to make the process as painless as possible
  • from the nose or mouth, introduce a flexible tube with a tiny fiber-optic camera or a bronchoscope into the lungs
  • using the bronchoscope, put the Zephyr Valves in the airways

The number of valves used by lung experts varies depending on which lung sections are clogged and contain trapped air, but it is usually four.

The treatment normally takes 30–60 minutes to complete.

The specialist removes the bronchoscope at the end of the procedure and monitors the patient during recovery.

After the procedure

According to the FDA, the patient may need to stay in the hospital for 3–5 days to recover from the procedure. The doctor keeps track on their progress in order to reduce any potential risks.

Antibiotics or other medications may be prescribed to help with any negative effects.

If the patient has no adverse reactions to the procedure, the hospital will provide them a wallet-sized patient ID card stating that they have Zephyr implants in their lungs.

Individuals must carry this card with them at all times and present it whenever they require medical attention, an emergency, or an MRI scan.

Additionally, the healthcare team may advise the patient to continue taking the prescribed medication, since this may aid in the treatment of their severe emphysema and reduce the risk of infection.

Following that, the patient may be required to return to their doctor for follow-up appointments to discuss their progress.

What can it assist you with?

People with severe emphysema can benefit from the Zephyr Valve therapy.

The following are some of the disease’s symptoms:

  • shortness of breath, from physical activity to typical day-to-day activities
  • feeling of tightness in the chest
  • coughing and wheezing
  • whistling sounds when breathing
  • coughing with mucus

Some people, however, are unable to undergo the Zephyr Valve surgery. These are people who:

  • cannot undergo a bronchoscopy procedure
  • have passages in their lungs that bypass the unaffected airways
  • have an active lung infection
  • have an allergy to nitinol, nickel, titanium, or silicone

Individuals who choose the Zephyr technique must also stop smoking for at least four months prior to treatment.

Benefits

Those who have Zephyr Valve treatment may reap a number of advantages. These are some of them:

  • Reduced shortness of breath: A study published in 2020 looked examined the impact of Zephyr Valves on people who suffer from dyspnea, or shortness of breath. Over the course of a year, people with severe emphysema reported less dyspnea.
  • Increased exercise ability: According to a 2018 study, 54.9 percent of people were affected Zephyr Valve therapy were able to resume employment, leisure, and exercise activities that had previously been difficult for them.
  • Easier long-term breathing: According to a 2018 study, people who had valves implanted in their airways to treat emphysema had higher lung function and exercise ability. Long-term breathing becomes easier as a result of this.
  • Increased life quality: In four distinct randomized controlled clinical trials, people who used Zephyr Valves reported a higher overall quality of life.

Risks

Risks and Side Effects of Zephyr Valve Treatments There are risks and side effects to consider with Zephyr Valve treatments. During the first 45 days after the surgery, they are more common.

Pneumothorax

Pneumothorax happens when there is an air leak or a rip in the lung, which usually occurs within the first 45 days after procedure.

During the treatment term, 26.6 percent of research participants experienced pneumothorax, the most common major adverse event, according to a randomized controlled study.

During the therapy period, 23.3 percent of the 43 patients had pneumothorax, according to another study.

The severity of a pneumothorax determines how it is treated. In the event of a little air leak, the person will require oxygen therapy and rest. In more serious circumstances, a doctor may need to use one of the following ways to operate on the patient:

  • Decompression of the needle: A hollow needle is inserted into the chest by the surgeon. They use a syringe to extract air from the area between the lungs and the chest using the needle.
  • Thoracostomy tube: To remove extra fluid, blood, or air, a surgeon makes an incision in the chest and inserts a tube between the lungs and the chest wall.

In severe cases of pneumothorax, all of the valves may need to be removed.

Pneumonia

Pneumonia is an infection that causes inflammation and fluid or pus to fill the air sacs in the lungs.

Among the signs and symptoms are:

  • sharp chest pain that worsens with deep breathing or coughing.
  • fever
  • cough, potentially with mucus

The risk of pneumonia varies. From the day of the Zephyr Valve procedure to 45 days later, one study found a 4.7 percent risk of developing the condition. Furthermore, from 45 days following therapy through the 12-month follow-up, 9% of study participants reported pneumonia as an adverse event.

A doctor will do multiple tests to confirm the diagnosis if there is a risk or suspicion of pneumonia. Blood tests, X-rays, bronchoscopies, and CT scans are examples of these tests.

Pneumonia is treated with rest and increased fluid intake, as well as antibiotic, antiviral, and antifungal drugs.

Worsening of emphysema or COPD

During the first 45 days after the pneumothorax study above, 19.5 percent of trial participants had worsening COPD symptoms, compared to 11.3 percent of the control group who merely got normal medication.

56.6 percent of the patients had worsened COPD or emphysema by the 12-month visit, compared to 56.5 percent of the control group.

However, there is little evidence to explain why the Zephyr Valve can help some people with emphysema while worsening symptoms in others.

Increased shortness of breath

Within 45 days of the operation, 16.4% of subjects in one trial developed dyspnea.

Within 30 days of receiving the Zephyr Valve, 2.3 percent of the 93 individuals experienced increased dyspnea, according to another study.

Death

One death was recorded by Impact Research 12 months after the valve was implanted.

In this trial, 3.1 percent of participants died within 45 days of the surgery, with one more dying by the 12-month follow-up visit.

Alternative treatments and products

Because there is currently no cure for emphysema, people who are experiencing symptoms should consult a doctor about condition options.

Treatments that are not conventional include:

  • Changes in your way of life: Avoiding or quitting smoking, as well as secondhand smoke, can help to lower the risk of respiratory problems. It may also prevent existing issues from worsening.
  • Oxygen therapy: This may aid in increasing oxygen levels in the lungs and circulation.
  • Prescribed medication: Bronchodilators, which come in the form of inhalers, relax the muscles surrounding the airways, allowing people to breathe more easily.
  • Pulmonary rehabilitation: Individuals with chronic breathing problems may benefit from a program that includes psychological therapy, exercise, and dietary support.
  • Surgery: A doctor or surgeon may prescribe surgery if severe emphysema symptoms do not improve with medication and therapy. Lung transplants, for example, are a procedure that involves removing damaged lung tissue, removing air holes that interfere with breathing, or removing damaged lung tissue. For people who aren’t a good fit for the Zephyr Valve, other options include lung volume reduction surgery and lung transplantation.

Conclusion

Individuals with severe emphysema or COPD may benefit from Zephyr Valves.

The method is noninvasive and permits airflow to reach the healthy parts of the lungs while stopping incoming air from colliding with the damaged parts.

Because the healthy parts of the lungs can expand as blocked air or fluids release over time, the procedure may enhance a person’s breathing. Shortness of breath is reduced with valve therapy, allowing the patient to live a more active lifestyle.

For people who are unable to have Zephyr Valve treatment, doctors may offer medicines or pulmonary rehabilitation as alternatives.

Sources:

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373582/
  • https://www.atsjournals.org/doi/full/10.1164/rccm.201803-0590OC
  • https://medlineplus.gov/emphysema.html
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  • https://www.copdfoundation.org/About-Us/Press-Room/Press-Releases/Article/1391/FDA-Approves-Zephyr-Endobronchial-Valve-For-Treating-Severe-Emphysema.aspx
  • https://www.ncbi.nlm.nih.gov/books/NBK441885/
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