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What You Need to Know About the Zephyr Valve for COPD

Medically reviewed by Adithya Cattamanchi, M.D., Pulmonology — By Cathy Lovering on October 12, 2022The Zephyr valve is a device that can improve breathing in people with emphysema, one of the two most common types of chronic obstructive pulmonary disease (COPD). The valve received approval by the Food and Drug Administration (FDA) in 2018. The FDA expedited its approval, designating it as a “breakthrough device.” That means the device offers more effective treatment for a life-threatening condition than current treatments. Results from clinical trials showed the Zephyr valve to:increase lung functionreduce shortness of breathimprove quality of life But the procedure comes with some risks and requires a multiple-day hospital stay. Still, it may hold great promise for those with COPD, specifically severe emphysema, who are looking for new treatments.

What is a Zephyr valve and how does it work

A Zephyr valve is a device to release trapped air in damaged parts of your lungs. Emphysema causes the air sacs in your lungs to lose their elasticity. When you breathe, air gets trapped in these sacs and doesn’t escape when you exhale. Over time, these parts of your lungs become overinflated. This puts pressure on the healthy parts of your lungs, making it harder to breathe. A Zephyr valve is a one-way valve doctors place in your airway. It allows trapped air to escape but prevents new air from entering the damaged part of your lung. Share on PinterestIllustrated by Jason Hoffman

What are the benefits of Zephyr valves

Results from clinical trials published in 2018 showed that many participants experienced increased lung function and better quality of life 12 months after receiving the valves. Specifically:Almost half (47.7%) of participants who received the valves had a 15% or greater increase in lung function.Participants who received the valves had increased exercise capacity, measured in their ability to walk farther.Those who received valves also had less shortness of breath during day-to-day activities.

What are the risks of Zephyr valves

The study found that over the long term (up to 1 year), adverse events that affected breathing were comparable between people who received the valves and people who didn’t. In the short term (during the first 45 days), those who received valves had a greater risk of some side effects. From most to least frequent, they were:pneumothorax (collapsed lung)chest painCOPD exacerbationscoughshortness of breathhemoptysis (coughing up blood)pain in their throatpleural effusion (fluid in their lung)chest discomforthypoxia (low oxygen)respiratory failure About 35% of people who received the valves had a serious adverse event in the first 45 days. In 3% of those people, an adverse event led to death.

Am I eligible to receive a Zephyr valve

The Zephyr valve is for people ages 40 to 75 years old with severe emphysema and whose lungs are large due to trapped air. Before you receive the valve, a doctor or healthcare professional may test your lung function to see if you’re a candidate. A doctor will also need to test if you have collateral ventilation in the lobes of your lungs. This means that air from one lobe of your lung can move into another lobe. Zephyr valves aren’t likely to work if you have collateral ventilation. A doctor may use the Chartis system to check for collateral ventilation. This involves a bronchoscopy and a catheter with a balloon tip that inflates to block off airways in your lung. According to 2020 research, this is a safe and accurate way to check for collateral ventilation. But even if your lung function makes you a candidate, other factors may exclude you from receiving a Zephyr valve. You may be ineligible if:You have an active lung infection.You’re allergic to Nitinol, nickel, titanium, or silicone.You have an air pocket greater than one-third the size of your lung.You can’t have a bronchoscopy.You had a prior lung transplant or major lung procedure.You’re actively smoking. You should also speak with a doctor about your eligibility if you’ve had a recent cardiac event such as a heart attack.

What is the procedure for inserting a Zephyr valve

A doctor places the Zephyr valves into your lungs through a procedure called a bronchoscopy. The procedure happens in a hospital or clinical setting. It lasts about 30 to 60 minutes. You’ll receive medication prior to the procedure. It should make you feel drowsy. The doctor inserts a bronchoscope into your lungs through your nose or mouth. A bronchoscope is a long tube with a camera on the end to help the doctor see where to place the valves. The doctor places Zephyr valves into your airways through the bronchoscope. How many you receive depends on your lungs, but most people receive about four. The doctor then removes the bronchoscope. You’ll have to stay in the hospital for at least 3 nights for observation. You may have to stay longer if you experience a complication such as a tear in your lung. You should be able to get back to your regular daily activities within a few weeks. The doctor may prescribe medications such as antibiotics or steroids after the Zephyr valve procedure.

What other treatments are available for people with COPD

If you live with COPD, a doctor can help you find ways to manage the condition. These options may include:Medication: Medications such as bronchodilators and steroids can help reduce symptoms such as coughing or wheezing.Oxygen therapy: Portable oxygen can help if your blood oxygen level is low.Pulmonary rehabilitation: Pulmonary rehab combines exercises with education to improve your quality of life. This can include learning how to manage your energy levels, breathe better, and choose food and exercise to support your health. In severe cases, a doctor may recommend surgery or a lung transplant to treat COPD.

Frequently asked questions

How much do Zephyr valves cost

Zephyr valves are sold only under the direction of a physician. Many people have the cost of the procedure and valves covered by private insurance.

Will insurance or Medicare cover a Zephyr valve

Medicare might not cover the cost of the Zephyr valve procedure. Private insurance policies may cover the cost. The company that makes the Zephyr valve, Pulmonx, has a patient reimbursement program to help people with the insurance process.

How long do Zephyr valves last

Zephyr valves are designed to stay in your body permanently. But they can be taken out if necessary. About one in five people need to have a doctor adjust their valves at some point. During an adjustment, they’ll replace the old valve with a new one.

Do I need to quit smoking before getting a Zephyr valve

Yes, if you still smoke, you’re not eligible to receive a Zephyr valve. You need to be smoke free for 4 months prior to screening.

Do I still need to take COPD medications if I have a Zephyr valve

Yes, you continue with your COPD medications after receiving a Zephyr valve. You’ll return to the doctor for a checkup after the procedure and can discuss if any of your prior treatments need changing with the Zephyr valve.

Takeaway

Emphysema, a type of COPD, can cause a buildup of air in damaged areas of your lungs. This causes pressure on the healthy areas of your lungs and makes it harder to breathe. The Zephyr valve is a one-way valve a doctor inserts to permanently guard your airway. It releases trapped air and prevents new air from entering the damaged areas. The valve can help improve lung function and quality of life in people with severe emphysema. Last medically reviewed on October 12, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Chronic obstructive pulmonary disease (COPD): Overview. (2019).
nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/COPD: Symptoms, diagnosis, and treatment. (2021).
cdc.gov/copd/features/copd-symptoms-diagnosis-treatment.htmlCriner GJ, et al. (2018). A multicenter randomized controlled trial of Zephyr endobronchial valve treatment in heterogeneous emphysema (LIBERATE).
atsjournals.org/doi/full/10.1164/rccm.201803-0590OCFDA approves novel device for treating breathing difficulty from severe emphysema. (2018)
fda.gov/news-events/press-announcements/fda-approves-novel-device-treating-breathing-difficulty-severe-emphysemaFind answers to frequently asked questions. (n.d.).
uspatients.pulmonx.com/frequently-asked-questions/Pulmonx Zephyr endobronchial valve: Instructions for use. (n.d.).
accessdata.fda.gov/cdrh_docs/pdf18/P180002C.pdfU.S. reimbursement resources. (n.d.).
pulmonx.com/reimbursement/Weinker J, et al. (2020). Predictive value of Chartis measurement for lung function improvements in bronchoscopic lung volume reduction.
ncbi.nlm.nih.gov/pmc/articles/PMC7339075/Welling JBA, et al. (2018). Chartis measurement of collateral ventilation: Conscious sedation versus general anesthesia - A retrospective comparison.
ncbi.nlm.nih.gov/pmc/articles/PMC6390462/Zephyr endobronchial valve - A new treatment for severe emphysema. (n.d.).
nyp.org/sites/default/files/acquiadam/2020-08/zephyr-patient-guide-en-us.pdfOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 12, 2022 By Cathy Lovering Edited By A. L. Heywood Medically Reviewed By Adithya Cattamanchi, MD Copy Edited By Kristin Hitchcock Share this articleMedically reviewed by Adithya Cattamanchi, M.D., Pulmonology — By Cathy Lovering on October 12, 2022

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