Am I a Candidate for Zephyr Valves? What You Should Know

I first heard about endobronchial valves – often referred to by the brand name Zephyr valves – around 2015. Back then, they were still being studied, and many of us in respiratory care were curious about them. The idea was simple but intriguing: If doctors could reduce the effect of the most damaged parts of the lung, breathing might become easier for people with severe emphysema. ^1-3

Over the years, I’ve heard several success stories. Most came from colleagues working at larger hospitals. Others came from patients themselves. But one thing I’ve also learned is that not everyone with COPD qualifies for this procedure. That leads to the question many patients ask: Am I a candidate for Zephyr valves?

How to know if you should try Zephyr valves

The answer depends on several factors. In emphysema, parts of the lungs become damaged and lose their elasticity. Air goes in when you inhale, but it doesn’t come out very well when you exhale. Over time, those areas remain inflated and trap air.^1-3

Respiratory therapists often describe this as hyperinflation. These overinflated areas take up space in the chest. Meanwhile, healthier parts of the lungs have less room to expand. When that happens, breathing becomes harder, and the feeling of shortness of breath increases.^1-3

Zephyr valves are tiny 1-way valves placed into certain airways during a bronchoscopy procedure. They allow trapped air to escape from the damaged part of the lung, but they prevent air from going back in. ^1,3,4

Over time, that damaged section of the lung can deflate slightly. When it does, healthier parts of the lung may have more room to expand. For some patients, that extra space can make breathing easier.^1-4

As promising as this treatment can be, it only works in certain situations. One of the first things doctors look at is how emphysema is distributed in the lungs. Zephyr valves tend to work best when 1 area of the lung is much more damaged than the surrounding areas. If the disease is spread evenly throughout the lungs, the valves may not provide much benefit.^2,3

Another important factor is something called collateral ventilation. In some lungs, air can move between lung segments through small natural connections. If those connections are present, air may simply bypass the valve and refill the treated area anyway.^2,3

When that happens, the valve cannot do its job. Doctors often perform special tests during the evaluation process to determine whether collateral ventilation is present.^2,3

Diagnostic and imaging tests are crucial

Pulmonary function tests and CT scans are also important when deciding whether someone might benefit from Zephyr valves. Patients who qualify usually have severe emphysema with significant air trapping, but they still need enough lung function to benefit from the treatment.⁵

If lung function is not impaired enough, the valves may not provide much improvement. On the other hand, if the disease is extremely advanced, the procedure may not be safe or helpful. That’s why doctors carefully review imaging studies, breathing tests, and other measurements before recommending the procedure.⁵

Addressing lifestyle factors

Doctors also look at a few practical things. Patients usually need to have stopped smoking, and they must be able to tolerate the bronchoscopy procedure used to place the valves. Doctors may also consider overall health and whether someone has frequent lung infections. All of these factors help determine whether the potential benefits outweigh the risks.⁶

Hearing that you are not a candidate for Zephyr valves can be disappointing. But it doesn’t mean there are no treatment options. Pulmonary rehabilitation, medications, oxygen therapy, and other treatments can still make a meaningful difference in quality of life. For patients who do qualify, Zephyr valves can sometimes improve breathing and reduce shortness of breath.^2,4,6

Talk to your doctor

Like many treatments in medicine, the key is finding the right treatment for the right patient. If you’re curious about whether Zephyr valves might help you, the best place to start is a conversation with your pulmonologist. They can review your tests and determine whether the procedure might be worth exploring.⁴