Myths and Legends: Do Bronchial Valves Have a Role in the Management of Emphysema?

Emphysema and chronic obstructive pulmonary disease are highly prevalent disease states. Patients with severe emphysematous disease have been shown to benefit from lung volume reduction surgery, at the cost of increased perioperative mortality. Interest in minimally invasive bronchoscopic lung volume reduction has increased over the past 2 decades, with endobronchial valves (EBVs) being the most studied of these modalities. Currently, there are 2 such devices that are US Food and Drug Administration approved, Zephyr and Spiration. Here, we have reviewed the literature with regard to EBV placement, highlighting how previous trials have informed current indications for valve placement. This article also reviews the potential benefits of EBVs and the associated complications. Although bronchial valves have yielded promising results and are a potentially safer alternative to lung volume reduction surgery, further guidelines are needed to improve patient selection and procedure performance. Myth: In severe emphysema, surgical resection is the only option for lung volume reduction.