BACKGROUND: Emphysema is a condition in which there is over-inflation of structures in the lungs known as alveoli or air sacs. This over-inflation results from a breakdown of the walls of the alveoli, which causes breathlessness and a decrease in respiratory function. Damage to the air sacs is irreversible and results in permanent holes in the tissue of the lower lungs. Early symptoms of emphysema include shortness of breath and cough. The patient experiences great difficulty exhaling. Emphysema doesn’t develop suddenly; it comes on gradually. Years of exposure to the irritation of cigarette smoke usually precede the development of emphysema.

Emphysema is the fourth most common cause of mortality in the U.S., according to the National Emphysema Foundation. Almost 3 million Americans live with the disease, and approximately 120,000 die each year.

STANDARD TREATMENT: Standard treatment for patients with emphysema includes:

» Quitting smoking: Experts say quitting smoking is the single most important factor for maintaining healthy lungs.

» Antibiotics: These can help treat bacterial infections, which are common among patients with emphysema.

» Bronchodilator drugs: These prescription drugs relax and open up air passages in the lungs. They may be inhaled or taken orally.

» Exercise: Doctors recommend breathing exercises to strengthen muscles.

» Lung transplantation: Recent studies have shown encouraging results for patients who undergo this procedure.

» Lung volume reduction surgery: Surgeons remove some of the more diseased portions of the lung. This increases available space in the chest cavity and allows the patient to breathe better.

NEW TREATMENT: Now, patients have one more non-surgical option for the treatment of emphysema. Jonathon Truwit, M.D., is the division head of the Division of Pulmonary and Critical Care Medicine at the University of Virginia in Charlottesville. He is studying a new procedure in which small valves block the entry of air into parts of the lungs that are affected by disease. Dr. Truwit implants the tiny valves while the patient is under anesthesia. Using a bronchoscope, he typically inserts six to nine of the valves. "We think the risk to the patient is going to be much lower because of the decreased operating room time and the decrease recovery time," says Dr. Truwit. "They can go out of the hospital the next day."

So far, the procedure has only been performed on about 75 patients across the country. "Their shortness of breath has been significantly reduced. Their quality of life has improved," he says. This surgery opens up one more option for patients who are not healthy enough to undergo a lung transplant or other surgical procedures for their emphysema. There are some risks, however. Approximately 7 percent of patients have suffered a collapsed lung.