Frequently Asked Questions about LVRS (Lung Volume Reduction Surgery)

Q. What is Lung Volume Reduction Surgery?

A. Lung volume reduction surgery (LVRS) is a surgical procedure where the worst areas of damaged lung tissue are removed. This surgery can be performed by either median sternotomy or video-assisted thoracic technique.

The median sternotomy involves cutting through the breastbone to open the chest. The video-assisted thoracic procedure involves making 3 to 5 small incisions in both sides of the chest to allow the surgeon to insert instruments between the ribs and into the chest.

The goal of the surgery, with either operative technique, is to remove up to 30 % of the lung volume and therefore make the lungs smaller.

Q. Does insurance cover lung volume reduction surgery?

A. Coverage for lung volume reduction surgery is determined by the type of insurance plan one has. Most private insurance plans cover the procedure, while Medicare covers lung volume reduction surgery with condition. Financial counselors at the LeBuhn Center help our patients to determine what coverage they are entitled to.

Q. How do know I if I am a candidate for LVRS?

A. If you are interested in being evaluated for possible lung volume reduction surgery, you should call the Center for Lung Failure at 212.305.1158 to obtain a patient questionnaire. You will need to discuss your interest in LVRS with your primary physician, who will be asked to provide your background information to us including history, pulmonary function, and x-ray studies.

The staff at the Center for Lung Failure will review the following information to determine whether you're a candidate for an on-site evaluation: Completed questionnaire * Pulmonary Function Test * Chest x-ray (film & report) * Pulmonologist notes

After this review, the staff will contact you by phone to discuss the next step in the evaluation process. Appropriate candidates will be invited to the center for 2 days of outpatient testing. The following tests are done at the Center: Chest X-ray *CT scan of chest * Perfusion scan of lungs * Blood tests (alpha1 antitrypsin; Cotinine level) * Complete pulmonary function test with lung volumes by plethsymography * Room air arterial blood gas * Dobutamine stress test of heart * Cardiopulmonary exercise test *

After the completion of these tests, the pulmonologist and surgeon then evaluate the interested patient. Jointly they make the decision as to the candidate's eligibility to proceed with lung volume reduction surgery. All patients, whether surgical candidates or not, are evaluated for and prescribed a pulmonary rehabilitation program by the rehabilitation medical physician during their evaluation at the Center.

If a patient is accepted for surgery, they will be referred to a 6-week outpatient pulmonary rehabilitation program. They will return for a final preoperative check up about one week prior to the termination of the rehab program. At this time surgical consent is obtained, surgery scheduled and preoperative testing including an evaluation by an anesthesiologist is performed. All arrangements are made with the patient and his or her family and the staff at the Center for Lung Failure.