The MetroHealth System has performed the first successful endobronchial valve surgery, bringing a potentially life-changing treatment for emphysema to the population at highest risk of emphysema.
Emphysema, a type of chronic obstructive pulmonary disease (COPD) caused by smoking, destroys the elasticity of the lungs, reducing their ability to release trapped air and causing them to overinflate. If the lungs are too inflated, breathing becomes difficult. A one-way endobronchial valve, called a Zephyr valve, is placed in the bronchial tubes of the lungs to allow air to escape while also preventing more air from becoming trapped.
The valve is left in place during the bronchoscopy and does not require an incision. Although the procedure itself is considered low risk, the patient is hospitalized for 3 nights for monitoring because of the risk of pneumothorax (leakage of air from the lungs into the pleural space), a risk lower than the initial risk. It will heal after a few days.
Dr. Arvind Suguness and the MetroHealth respiratory team performed the procedure on the first patient at the end of March. This treatment has been in use since his 2018, and Dr. Suguness saw its potential early on. During his fellowship in Washington, DC, he worked with a leading surgeon.
Dr. Suguness was impressed with the successful results, with patients improving lung function, increasing their exercise capacity and improving their overall quality of life. So when he joined MetroHealth in 2020, he was eager to bring what he’s learned to patients here. But when the pandemic turned the respiratory team’s attention to his COVID-19 case in his ICU, his plans to start the Zephyr valve program were put on hold.
But now, after a year of planning and working with multiple departments across the system, including trauma surgery and anesthesiology, the team has identified more patients who could benefit from Zephyr valve therapy, and the surgery. is setting a schedule. To be eligible for valve therapy, people must meet certain criteria, such as agreeing to quit smoking. And it’s no small consideration.
Smoking prevalence in MetroHealth’s patient population is high, many are affected by social factors in their health such as discrimination and poverty, and the Centers for Disease Control (CDC) has identified these as risk factors associated with commercial tobacco use. I am specifying.
According to the CDC’s Office of Smoking and Health, “For decades, tobacco companies have used promotions, targeted marketing, and other tactics to increase the access and attractiveness of tobacco products to specific population groups. Discrimination, poverty, and other social conditions are also associated with tobacco product use and can make quitting smoking difficult.”
For Dr. Suguness, this illustrates the urgency to start this program and deliver its benefits to MetroHealth patients.
“It takes a lot of resources to set up a program like this. It can get really difficult when you have a lot of other demands on your time,” he said. , COPD and emphysema patients often have few options, and like many at MetroHealth, I came here because I wanted to serve the underserved. Because being able to breathe is very basic for the rest of your life, and I thought it was really important for patients to have this option.”
Donald Bass, who turns 70 this year, was the first patient to receive a Zephyr valve. He said quitting smoking was the most difficult part of his procedure, but he couldn’t pass up the chance to breathe easier, he said. So he quit smoking eight months before him. He says he will never pick them up again.
“Dr. Sugnes said he knew of a cure to help him breathe, but he said, ‘I need to quit smoking first,'” Donald said. “Every day I thought about everything he said. I could see that he was very worried about me, so I really did it for him. Such a doctor Not many.”
Two weeks after surgery, Donald strolled through Walmart. He was able to leave the oxygen tank in his car and go shopping. This was a joy many years ago. Now he hopes to be able to ride a bike again. Dr. Suguness says it may be possible one day.
“Many benefits are not immediate,” says Dr. Suguness. “But I think his change is good.”