Relief for victims of lung disease – found in a ketchup bottle

BREATHLESSNESS caused by long-term lung disease can be crippling, leaving patients housebound and unable to take even a few steps without gasping for air.

But now those blighted by the distressing condition could see their lives transformed – thanks to a tiny valve implant which works in a similar way to easy-squeeze ketchup bottle tops.

The alloy and silicone device is being offered to NHS patients with emphysema and other incurable respiratory problems, collectively known as chronic obstructive pulmonary disease, or COPD. In these patients, deformity and loss of elasticity in lung tissue means that air enters the lung but cannot be pushed back out.

The valve, placed deep in the tiny branches within the lungs known as bronchioles, allows air to flow but in one direction only. The concept is similar to the way rubber tops of ketchup bottles work.

This effectively cuts off the diseased areas of the lungs. Despite the volume of the lungs being smaller, the valve actually improves breathing because air flows through the healthy areas of the organ only.

Two recent studies have shown promising results, with one reporting a 30 per cent improvement in lung function in COPD patients compared to patients given standard treatments.

The second study found that 43 patients suffering from severe emphysema experienced ‘clinically meaningful improvements in lung function, exercise tolerance and quality of life’ just three months after having the valve implanted.

About 1.2million Britons suffer from COPD, an umbrella term for a number of lung diseases that include chronic bronchitis. Damage usually caused by smoking leads the tiny oxygen-absorbing surfaces within the lungs, known as alveoli, to break down and lose function.

Not only is oxygen not absorbed, but air becomes trapped within the lungs, stretching them.

This increase in volume puts pressure on the muscles surrounding the organs, making it even harder to breathe.

Patients are often offered surgery to remove damaged sections of lung so that healthy ones can function better. But this carries risks, and can mean a prolonged stay in hospital.

Other surgical procedures involve using heat or other forms of energy to collapse the diseased sections of the lungs, reducing the volume.

The new procedure allows surgeons to close off damaged sections of lung without removing or causing further harm to tissue.

The Zephyr valves consist of a collapsible nickel and titanium alloy wire outer ‘basket’ – not unlike a stent used in heart surgery – which surrounds the silicone inner valve.

The flexible material is constructed in such a way as to form a one-way valve. The implantation takes about 45 minutes and the procedure may be done under sedation or general anaesthetic.

Surgeons use a thin flexible tube called a bronchoscope to implant the valve, threading it into the lungs via the mouth and windpipe. Once in the correct position, the wire basket expands, holding the device in place.

Dr Samuel Kemp, consultant respiratory physician at the Royal Brompton & Harefield NHS Foundation Trust, who led one recent study using the Zephyr, says: ‘After the procedure, patients can breathe more easily, walk further, dress themselves and generally have a better quality of life.

‘Being breathless is miserable and people become afraid to exercise. But this gives them back their confidence and their quality of life without surgery, and may be suitable for many more patients with emphysema.’

ALAN Kirk, consultant thoracic surgeon at the Golden Jubilee National Hospital, near Glasgow, adds: ‘Selected patients respond very well. ‘Unlike other techniques for lung volume reduction surgery, this is reversible. So although five per cent of patients have problems with infection or displaced valves, we can simply take the valve out.

‘We monitor them in hospital for three days, since there is a onein-five risk of a collapsed lung. This has revitalised our approach to these patients, since two years ago we had very little to offer them.’

David Chalmers, 69, a retired facilities manager from near Salisbury in Wiltshire, was diagnosed with emphysema in 2006 after a severe chest infection.

He stopped smoking immediately and took medication, but his condition gradually worsened until he was unable to work in the garden or wash the car, and he could walk only 150 yards.

Then in January he had the valves fitted at the Royal Brompton as part of the trial. ‘It’s taken ten years off me,’ he says. ‘I can now enjoy gardening, walk a mile and climb stairs without stopping. It’s a fantastic improvement.’