A “Breath-Giving” Procedure for COPD and Emphysema

Rick Scroggins has worked hard and played hard throughout his 75 years. So, it didn’t sit well with him when severe emphysema and chronic obstructive pulmonary disease (COPD) forced him to slow down and rely on oxygen treatment to handle even minor daily tasks. In fact, it was so bad, that it took him minutes to climb the 12 steps to his home office, while having to stop and rest at each landing after four steps. “I’ve gone 110 miles per hour my whole life,” he says. “It’s very difficult for me to have to slow down.”

Thanks to the experts at The Christ Hospital Physicians – Pulmonary Medicine, and a breakthrough minimally-invasive treatment called The Zephyr Valve, Rick is back to enjoying long periods of physical activity, usually without the need for external oxygen.

Zephyr Valve - A groundbreaking and “breath-giving” procedure

The lungs of patients with COPD are often damaged and can get clogged with or blocked by phlegm, which restricts airflow and can cause air to be trapped in the damaged lobes. This restricts the ability for other lobes to inflate properly, causing shortness of breath and restricting the intake of air/oxygen, which can lead to many other health concerns such as heart problems, weakened muscles and brittle bones, and depression and anxiety.

The Zephyr Valve is a minimally invasive treatment qualifying patients with COPD and emphysema that involves the insertion of valves through the airway and into a lung with no incision required. They make it easier for patients to breathe by deflating and restricting airflow to the more damaged lobe(s), which lessens the restriction on the healthier adjacent lobes.

Eligible patients are typically those with moderate to severe emphysema, and stage three or four COPD, according to Vishal Jivan, MD, the pulmonologist with The Christ Hospital Physicians-Pulmonary Medicine who implanted the five valves in Rick’s lungs. Patients undergo a series of testing and scans to determine if the valves will work for them, and to identify the best location to implant them.

“We’re looking to deflate the part of the lung that has the most emphysema, and the lowest amount of blood supply,” Dr. Jivan says. “This diverts the airflow to the healthier lobes which were impeded by the lobe with more emphysema and allows them to supply more oxygen to the blood, which gives the patient more energy.”

Some patients, including Rick, see a significant reduction in the need for the use of external oxygen, but Dr. Jivan reminds his patients that isn’t the case for everyone. Still, he says, even if they still need oxygen, the differences in their breathing, energy, and stamina are noticeable.

“We’re looking for a difference in tolerance for exercise and physical activity,” he says. “Even for those who still require oxygen, they’re going to notice a big difference in that tolerance. I recently spoke with a patient who was excited to be able to walk around a county fair for four hours, where before, he couldn’t walk for more than an hour.”

What to expect after a Zephyr Valve procedure

The procedure to implant the valves is minimally invasive with little physical stress on the patient, and according to Dr. Jivan, patients can notice an immediate difference, and continue to feel better in the weeks after receiving the implants. However, he points out that the valve does require a minimum three night stay for observation.

“There is a minor risk for a collapsed lung during the first three days, and it’s important for us to monitor for that during that period,” he says.

There is also a risk for the valves to come loose after they are implanted, often from the patient coughing. This isn’t a major concern, however, and Dr. Jivan points out that the procedure to remove and replace the loose valve is the same simple procedure as the original.

“It’s not a medical emergency and there’s very little risk to the patient when the valve comes loose,” Dr. Jivan says. “But they do experience a return of their original symptoms, so we like to move quickly to get them feeling better as soon as possible.”

Rick has experienced a valve coming loose from coughing. “It’s no big deal,” he says. “It’s the same easy procedure and well worth it.”

A lifesaving scan

Zephyr Valve implants require ongoing follow-up scans. When Rick went for a follow-up after having a loose valve replaced, the results indicated that a small nodule that had been previously detected during scans had grown. Rick had lung cancer.

Rick wasn’t going to lose his new-found momentum, however, and began the journey to beat the cancer.

“I had some help,” he says. “My wife and my daughter, who happens to be a nurse, were with me for every visit. I always tell me people, ‘I have my nurse and my bodyguard with me, I’ll be OK.”

Julian Guitron-Roig, MD​, a thoracic and cardiac surgeon with The Christ Hospital Physicians – Heart & Vascular, successfully removed the top lobe Rick’s right lung that contained the cancer. Then began the road to recovery, that was admittedly longer and more challenging than recovery from the valve implants, but after about a month of inpatient care, Rick’s back to enjoying his active life, but he wants people to know that he had help.

“The people at The Christ Hospital are great,” he says. “There are none better. And that’s not just Dr. Jivan, Dr. Guitron and the other doctors. That’s everybody from the nurses in the endoscopy department to the nurses in the stepdown unit after cancer surgery. In fact, I’ve told Katie, a nurse in the endoscopy department, ‘Your bubbly personality and positive attitude make this easier. You can take somebody having a terrible day and having to go through with this and make them feel like they are having the best day ever.”

Back to 110 miles per hour

Rick’s procedure did reduce the need for oxygen and he’s back to enjoying some his favorite activities with his family. “I’m not out here running any races,” he says, “but I’m comfortable to cover a lot of ground.”

He and his wife of more than 50 years have two adult daughters and four grown grandchildren, and they’ve always enjoyed travelling with their family. Rick is happy to be back to travel activities such as walking for miles on the beach in Florida or hiking in the mountains of Tennessee with his wife. He also enjoys helping out for hours at a time at the farm owned by his oldest daughter and her husband.

“It’s amazing what I can do that I couldn’t do before,” Rick says. “There’s no way I could have done any of this before those valves.”


Current patients can ask their primary pulmonologist if they believe they may be a candidate for a Zephyr Valve, or call our office at 513-241-5489 for ​more information. Ask your primary care provider about a referral if you believe you may be a candidate but if you are not an existing patient of The Christ Hospital Physicians - Pulmonary Medicine. ​


Vishal D. Jivan, MD

​​Vishal Jivan, MD, is a Board Certified physician specializing in pulmonary diseases and critical care medicine.

A “Breath-Giving” Procedure for COPD and Emphysema Moderate to severe COPD and emphysema can literally take your breath away. For patients who increasingly rely on external oxygen, a minimally invasive procedure is opening airways and restoring their energy.

Rick Scroggins has worked hard and played hard throughout his 75 years. So, it didn’t sit well with him when severe emphysema and chronic obstructive pulmonary disease (COPD) forced him to slow down and rely on oxygen treatment to handle even minor daily tasks. In fact, it was so bad, that it took him minutes to climb the 12 steps to his home office, while having to stop and rest at each landing after four steps. “I’ve gone 110 miles per hour my whole life,” he says. “It’s very difficult for me to have to slow down.”

Thanks to the experts at The Christ Hospital Physicians – Pulmonary Medicine, and a breakthrough minimally-invasive treatment called The Zephyr Valve, Rick is back to enjoying long periods of physical activity, usually without the need for external oxygen.

Zephyr Valve - A groundbreaking and “breath-giving” procedure

The lungs of patients with COPD are often damaged and can get clogged with or blocked by phlegm, which restricts airflow and can cause air to be trapped in the damaged lobes. This restricts the ability for other lobes to inflate properly, causing shortness of breath and restricting the intake of air/oxygen, which can lead to many other health concerns such as heart problems, weakened muscles and brittle bones, and depression and anxiety.

The Zephyr Valve is a minimally invasive treatment qualifying patients with COPD and emphysema that involves the insertion of valves through the airway and into a lung with no incision required. They make it easier for patients to breathe by deflating and restricting airflow to the more damaged lobe(s), which lessens the restriction on the healthier adjacent lobes.

Eligible patients are typically those with moderate to severe emphysema, and stage three or four COPD, according to Vishal Jivan, MD, the pulmonologist with The Christ Hospital Physicians-Pulmonary Medicine who implanted the five valves in Rick’s lungs. Patients undergo a series of testing and scans to determine if the valves will work for them, and to identify the best location to implant them.

“We’re looking to deflate the part of the lung that has the most emphysema, and the lowest amount of blood supply,” Dr. Jivan says. “This diverts the airflow to the healthier lobes which were impeded by the lobe with more emphysema and allows them to supply more oxygen to the blood, which gives the patient more energy.”

Some patients, including Rick, see a significant reduction in the need for the use of external oxygen, but Dr. Jivan reminds his patients that isn’t the case for everyone. Still, he says, even if they still need oxygen, the differences in their breathing, energy, and stamina are noticeable.

“We’re looking for a difference in tolerance for exercise and physical activity,” he says. “Even for those who still require oxygen, they’re going to notice a big difference in that tolerance. I recently spoke with a patient who was excited to be able to walk around a county fair for four hours, where before, he couldn’t walk for more than an hour.”

What to expect after a Zephyr Valve procedure

The procedure to implant the valves is minimally invasive with little physical stress on the patient, and according to Dr. Jivan, patients can notice an immediate difference, and continue to feel better in the weeks after receiving the implants. However, he points out that the valve does require a minimum three night stay for observation.

“There is a minor risk for a collapsed lung during the first three days, and it’s important for us to monitor for that during that period,” he says.

There is also a risk for the valves to come loose after they are implanted, often from the patient coughing. This isn’t a major concern, however, and Dr. Jivan points out that the procedure to remove and replace the loose valve is the same simple procedure as the original.

“It’s not a medical emergency and there’s very little risk to the patient when the valve comes loose,” Dr. Jivan says. “But they do experience a return of their original symptoms, so we like to move quickly to get them feeling better as soon as possible.”

Rick has experienced a valve coming loose from coughing. “It’s no big deal,” he says. “It’s the same easy procedure and well worth it.”

A lifesaving scan

Zephyr Valve implants require ongoing follow-up scans. When Rick went for a follow-up after having a loose valve replaced, the results indicated that a small nodule that had been previously detected during scans had grown. Rick had lung cancer.

Rick wasn’t going to lose his new-found momentum, however, and began the journey to beat the cancer.

“I had some help,” he says. “My wife and my daughter, who happens to be a nurse, were with me for every visit. I always tell me people, ‘I have my nurse and my bodyguard with me, I’ll be OK.”

Julian Guitron-Roig, MD​, a thoracic and cardiac surgeon with The Christ Hospital Physicians – Heart & Vascular, successfully removed the top lobe Rick’s right lung that contained the cancer. Then began the road to recovery, that was admittedly longer and more challenging than recovery from the valve implants, but after about a month of inpatient care, Rick’s back to enjoying his active life, but he wants people to know that he had help.

“The people at The Christ Hospital are great,” he says. “There are none better. And that’s not just Dr. Jivan, Dr. Guitron and the other doctors. That’s everybody from the nurses in the endoscopy department to the nurses in the stepdown unit after cancer surgery. In fact, I’ve told Katie, a nurse in the endoscopy department, ‘Your bubbly personality and positive attitude make this easier. You can take somebody having a terrible day and having to go through with this and make them feel like they are having the best day ever.”

Back to 110 miles per hour

Rick’s procedure did reduce the need for oxygen and he’s back to enjoying some his favorite activities with his family. “I’m not out here running any races,” he says, “but I’m comfortable to cover a lot of ground.”

He and his wife of more than 50 years have two adult daughters and four grown grandchildren, and they’ve always enjoyed travelling with their family. Rick is happy to be back to travel activities such as walking for miles on the beach in Florida or hiking in the mountains of Tennessee with his wife. He also enjoys helping out for hours at a time at the farm owned by his oldest daughter and her husband.

“It’s amazing what I can do that I couldn’t do before,” Rick says. “There’s no way I could have done any of this before those valves.”


Current patients can ask their primary pulmonologist if they believe they may be a candidate for a Zephyr Valve, or call our office at 513-241-5489 for ​more information. Ask your primary care provider about a referral if you believe you may be a candidate but if you are not an existing patient of The Christ Hospital Physicians - Pulmonary Medicine. ​


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