Zephyr Valve
NCH pulmonologists place tiny, one-way Zephyr Valves in the airways to treat severe COPD and emphysema — a minimally invasive, non-surgical alternative to lung volume reduction surgery, placed during a bronchoscopy with no incisions.
What Is the Zephyr Valve?
The Zephyr Valve is a small, one-way endobronchial valve, made by Pulmonx, that is placed in the airway to treat severe COPD and emphysema. In damaged areas of the lung, air becomes trapped and the lung overinflates, making it harder to breathe. The Zephyr Valve is designed to let that trapped air escape during exhalation while blocking new air from entering, so the diseased portion of the lung can deflate and nearby healthier lung tissue has more room to expand.
The valves are placed during a bronchoscopy — a procedure using a thin, flexible scope passed through the mouth or nose — so no incisions or cutting are required. On average, physicians place around four valves, though the exact number depends on each patient’s airway anatomy.
This approach, sometimes called bronchoscopic lung volume reduction (BLVR), offers select patients an alternative to traditional lung volume reduction surgery (LVRS), which is more invasive and requires a surgical incision.
Who Is a Candidate for the Zephyr Valve?
Your pulmonologist may recommend Ion robotic bronchoscopy when imaging has identified a lung nodule or mass that needs a tissue sample to help determine a diagnosis.
General Candidate Criteria
Patients who should be evaluated for Zephyr Valve treatment generally:
Confirmed COPD/Emphysema
A confirmed diagnosis of COPD or emphysema
Persistent Breathlessness
Frequent shortness of breath despite taking medication as directed
Reduced Lung Function
FEV1 ≤50% predicted on pulmonary function testing
Confirmed Non-Smoker
These are general criteria, not a guarantee of eligibility. A full evaluation — including a CT scan, pulmonary function tests, and a collateral ventilation assessment — is required before a treatment decision is made.
Why Collateral Ventilation Matters
The single most important test in the evaluation process:
Before valve placement, your physician measures whether air can bypass the airways and continue reaching the target lobe through alternate pathways — called collateral ventilation — using a CT scan and, during bronchoscopy, the Chartis Pulmonary Assessment System. Patients with little to no collateral ventilation (“CV-negative”) are the ones most likely to benefit from Zephyr Valve treatment; if significant collateral ventilation is present, the valves may not allow the target lobe to fully deflate, and treatment may not be recommended.
Not every patient with severe COPD/emphysema is a candidate for the Zephyr Valve. Your pulmonologist will review your imaging, breathing tests, and collateral ventilation results to determine whether valve therapy, continued medical management, pulmonary rehabilitation, or surgical lung volume reduction is the most appropriate option for you.
Your Procedure Journey
From evaluation through recovery, here’s what to expect at each stage.
Evaluation & Testing
CT scan, pulmonary function tests, and review of candidacy criteria
Preparation
Confirmed smoking cessation, medication review, pre-procedure instructions
Day of Procedure
Sedation given; bronchoscope inserted through the mouth or nose
Valve Placement
Collateral ventilation confirmed; on average 4 valves placed in the target airway
Hospital Monitoring
Minimum 3-night inpatient stay to monitor for pneumothorax and confirm response
Seek care immediately if you develop sudden or worsening shortness of breath, chest pain, or other symptoms that may indicate a pneumothorax, both during your hospital stay and after discharge. Download the full Prep Guide →
Is Zephyr Valve Treatment Right for You?
Weighing Zephyr Valve treatment against other options, and understanding the risks, are both part of deciding whether it’s the right path for your COPD/emphysema.
| Zephyr Valve | Lung Volume Reduction Surgery (LVRS) | Continued Medical Management | |
|---|---|---|---|
| Best for | Select CV-negative patients with severe heterogeneous or homogeneous emphysema | Select surgical candidates, often with upper-lobe predominant emphysema | Patients not yet candidates for a procedure, or preferring to optimize medication first |
| Method | One-way valves placed bronchoscopically to deflate a diseased lung region | Surgical removal of diseased lung tissue through an incision | Inhalers, oxygen therapy, and pulmonary rehabilitation |
| Setting | Bronchoscopy suite, no incisions, inpatient monitoring after | Operating room, general anesthesia, surgical recovery | Outpatient management |
| Typical stay/recovery | Minimum 3-night hospital stay; gradual improvement over weeks | Longer hospital stay and recovery than valve placement | Ongoing, no procedural recovery |
Risks & Safety
As with any procedure, the Zephyr Valve carries risks. Your physician will review your individual risk factors and discuss whether the potential benefits outweigh them for your situation.
Pneumothorax
A tear or air leak in the lung is the most common risk, usually occurring in the first several days; this is why an inpatient stay is required.
Worsening COPD Symptoms
Some patients experience a temporary worsening of symptoms after the procedure.
Hemoptysis & Pneumonia
Coughing up blood and pneumonia have been reported as possible complications.
Rare Serious Complications
In rare cases, complications can be serious, including death. Only a trained physician can determine if you’re an appropriate candidate.
Important safety information: The Pulmonx Zephyr® Endobronchial Valves are used to treat severe emphysema in select adults. Risks include pneumothorax, worsening COPD symptoms, hemoptysis, pneumonia, and, rarely, death. The valves are contraindicated in patients who have not quit smoking. Talk with your physician to determine if you are a candidate.
Results & Next Steps
In clinical studies, patients treated with Zephyr Valves have been shown to breathe easier, be more active, and enjoy an improved quality of life.1 Improvement typically develops gradually over the weeks following the procedure, as the treated portion of the lung deflates and nearby healthier lung tissue has more room to expand.
Your care team will follow up with imaging and breathing tests to confirm how well the treated lobe has responded. Some patients may need a repeat bronchoscopy to adjust or reposition a valve.
Zephyr Valve treatment does not cure COPD or emphysema — it is one part of an ongoing management plan that typically continues to include medication and pulmonary rehabilitation.
- Continued pulmonary rehabilitation
- Follow-up imaging and breathing tests
- Valve adjustment or repositioning
- Continued COPD/emphysema medications
- Evaluation for lung volume reduction surgery, if appropriate
- Ongoing pulmonology follow-up
Frequently Asked Questions
What is the Zephyr Valve?
The Zephyr Valve is a tiny, one-way implant placed in the airway during a bronchoscopy to treat severe COPD/emphysema. It lets trapped air escape a diseased part of the lung while blocking new air from entering, helping the lung deflate so healthier tissue nearby has room to expand.
How is the Zephyr Valve different from surgery?
Unlike lung volume reduction surgery, Zephyr Valve placement is done through a bronchoscope with no incisions or cutting. It’s generally considered a less invasive alternative for appropriately selected patients.
Who is a candidate for the Zephyr Valve?
Candidates generally have a confirmed diagnosis of COPD/emphysema, frequent breathlessness despite medication, and reduced lung function (FEV1 ≤50% predicted). A full evaluation, including a collateral ventilation assessment, is required to confirm candidacy — only a trained physician can make that determination.
Will I be awake during the procedure?
No. You will be given medicine to make you sleepy before the bronchoscope is inserted.
How many valves are placed?
On average, physicians place around four valves. The exact number depends on your individual airway anatomy and physician judgment.
Why do I need to stay in the hospital for 3 nights?
Pneumothorax (a tear or air leak in the lung) is the most common risk after valve placement and is most likely to occur in the first several days. A minimum 3-night inpatient stay allows your care team to monitor closely and respond quickly if it occurs.
What are the risks of the Zephyr Valve?
Possible complications include pneumothorax, worsening of COPD symptoms, hemoptysis, pneumonia, and, in rare cases, death. The Zephyr Valve is contraindicated in patients who have not quit smoking. Your physician will review your specific risks before treatment.
Do I need to quit smoking before treatment?
Yes. The Zephyr Valve is contraindicated in patients who have not quit smoking, and smoking status is confirmed as part of the candidacy evaluation.
Location
Consultations are available at NCH Pulmonary outpatient offices; the robotic bronchoscopy procedure itself is performed at an NCH hospital procedure suite under general anesthesia.
311 9th Street North, Suite 304, Naples, FL 34102
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Talk with an NCH pulmonologist about whether Zephyr Valve treatment is right for you.