Airway bypass improves the mechanical properties of explanted emphysematous lungs

Cliff K. Choong, Peter T. Macklem, John A. Pierce, Nitin Das, Barbara A. Lutey, Carlo O. Martinez, Joel D. Cooper

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Rationale: By creating artificial communications through bronchial walls into the parenchyma of explanted lungs (airway bypass), we expect to decrease the amount of gas trapped and to increase the rate and volume of air expelled during forced expirations. Objectives: To describe the mechanism by which airway bypass improves the mechanical properties of the emphysematous lung. Methods: Lung compartments and mechanics were measured before and after airway bypass, which was created by placement of three or four stent-suppported fenestrations in 10 emphysematous lungs removed at transplantation surgery. Measurements and Main Results: Minimal volume after passive deflation decreased by a mean of 1.54 L (range, 0.7-2.5 L) or 60% (range, 37-86%). Explanted VC increased by 1.30 L or 132% (range, 78-318%). Maximal expiratory flows and volumes increased. Flow resistance decreased. Conclusions: Because these data show that airway bypass improves the mechanics of breathing in severely emphysematous lungs in vitro, there is now strong empirical support that this procedure can improve ventilatory function in patients by reducing gas trapping and flow resistance.

Original languageEnglish (US)
Pages (from-to)902-905
Number of pages4
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number9
StatePublished - Nov 1 2008
Externally publishedYes


  • Airway bypass
  • Collateral ventilation
  • Transbronchial fenestrations

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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