How can I find out whether this treatment is right for me?

Ideally, through a triage visit to our Center, or a triage appointment with one of our clinicians. Visits may be scheduled by phone + (55 51) 3314.3434 or 9977.5554. The patient should bring his or her most recent tests and, if necessary, schedule an assessment as well.

I live nowhere near Porto Alegre and have a mobility impairment – how can I schedule an assessment?

You may send a family member in your place for the triage appointment, as long as he or she brings your most recent test results (chest CT and PFTs at the very least). A brief report from your treating physician (or your physician’s phone number if he or she cannot produce a report) can also help us in this situation.
You may also choose to send us your test results and physician report (as well as your physician’s contact information) by registered priority mail. If you choose to do so, please make sure to let our executive assistant know beforehand (call +55 51 9977 5554). These tests will be reviewed, and if our team of physicians believes one-way valve therapy may be right for you, you will be called to schedule an assessment at our facilities in Porto Alegre.

How does the assessment work?

The assessment is performed after triage, if our clinicians feel the treatment can help the patient. There are two types of assessment:

Outpatient: after triage, the clinician in charge of the case or the Center’s executive assistant will schedule the necessary tests. During outpatient assessment, the patient is not admitted to the hospital. Patients who are not from Porto Alegre may choose to stay at a hotel or at a relative’s home. When assessment is completed, the clinical team will get in touch with the patient to let him or her know whether one-way valve treatment is indicated. Outpatient assessment may take up to 5 days.

Inpatient: inpatient assessment is very similar to outpatient assessment. However, as the name implies, the patient will be admitted to the hospital for the duration of the assessment process. The Center’s executive assistant will be waiting for the patient on his or her arrival at the Hospital Moinhos de Vento. One of our clinicians will take charge of the patient’s care for the duration of the process and will request all necessary tests. After testing is completed, the team will convene and let the patient know whether one-way valve treatment is indicated. If so, the patient will simply remain in hospital for a few more days for the procedure.

Inpatient assessment usually takes 2 days, during which time the patient will remain at the Hospital Moinhos de Vento, either alone or with a companion. If our clinicians believe that treatment is indicated and the patient decides to stay for the procedure, 3 or 4 days will be added to the patient’s hospital stay. The cost of valve placement is calculated on a case-by-case basis for each patient, because it depends on the number of valves used.

What is the assessment like?

The assessment comprises a battery of pulmonary function tests, a six-minute walk test, a few laboratory tests, an echocardiogram, and a chest CT. Images obtained with a state-of-the-art, latest-generation CT scanner are moved to another Center device, which employs a unique software program known as VIDA. This device, the only one of its kind in South America, provides extremely precise and accurate information on the distribution of emphysema, the anatomy of the patient’s airway, and the presence of any other changes that may play a role in deciding on therapy and building a treatment plan. Our pulmonary function tests also follow a specific protocol designed for optimal planning and follow-up of the valve implantation procedure. Depending on the case, further assessment by other professionals (dietitian, physical therapist, psychologist or counselor) may be warranted, especially in treatment candidates.
The decision to go ahead with treatment is made in a multidisciplinary meeting, during which all aspects of the assessment are discussed. After this meeting, the proposed treatment plan and strategy are outlined to the patient, his or her family and his or her physician. The final cost estimate will also be provided, as the exact number of valves required will now be known.

How should I prepare for the procedure?

Before coming to the Hospital Moinhos de Vento, patients will receive an estimate of treatment costs, including valves, hospital admission and stay, and physician fees. This estimate must be approved by the patient. The Center will then set a date for admission and schedule all necessary tests. The patient or his or her relatives may also contact the Hospital’s Customer Information Service (+55 51 3314-3232) for more detailed financial information. The exact cost of treatment will only be known after our team has established precisely how many valves will be necessary (that is, after patient assessment).

How long has Hospital Moinhos de Vento offered this procedure?

The surgical team responsible for performing the procedure has existed since 2001, and originally provided this treatment at the Hospital de Clínicas de Porto Alegre. It was the first team in Brazil and Latin America to take part in a multinational trial that studied whether valve treatment could help patients with emphysema.

The Hospital Moinhos de Vento Emphysema Treatment Center was officially established in April 2008 by Dr. Hugo Goulart de Oliveira and Dr. Amarilio Vieira de Macedo Neto.

What is the success rate for the procedure?

Based on the results obtained by 50 patients treated by our Center physicians, over 85% of patients will experience improvement. Data in the scientific literature show that properly selected patients with heterogeneous-type emphysema experience a 15% improvement in spirometry parameters (FEV1) and in the six-minute walk test. Some patients may experience much more dramatic improvement. In some cases, this means being able to bathe or shower unaided again; in others, it will mean substantial improvement in breathing. Some patients may even cease to require supplemental oxygen. However, patients must bear in mind that the Emphysema Treatment Center does not offer a cure for emphysema, but an innovative new treatment to improve quality of life.

How long is the usual hospital stay for this procedure?

People admitted to the Hospital Moinhos de Vento for assessment can expect to spend 2 days in hospital. Patients selected for treatment will need to remain in the hospital for 2 or 3 more days after the procedure, for observation purposes.

Will my insurance cover this procedure?

No. At the present time, no insurance organizations provide coverage for this particular procedure.

What is the cost of this procedure?

Each patient receives an individualized estimate based on his or her case. Total treatment cost will depend on the number of valves required.

Can treatment cost be divided into installments?

Yes. Payment of hospitalization and treatment costs (including valve cost and physician fees) is fully negotiable. For more information, please contact us at (51) 3085.7470 and (51) 9977.5554 or nucleo@enfisema.com.br. You may also use our contact form.

Can the patient send any tests to the Hospital prior to assessment?

Yes, patients from outside Rio Grande do Sul or those who have trouble getting to the Hospital may mail us their tests (lung CT and pulmonary function tests) in advance for triage. Patients should send the most recent test results available. The Emphysema team will analyze the patient’s tests and let the patient know whether one-way valve treatment is a possibility.

Is this procedure covered by the Brazilian Unified Health System?

No. One-way valve treatment is privately funded; neither the national health care system nor any insurance organizations provide coverage for this procedure.

Is this procedure performed anywhere else in Brazil?

So far, the only facility in Brazil to offer one-way endobronchial valve treatment is the Hospital Moinhos de Vento in Porto Alegre. Groups in São Paulo, Rio de Janeiro, Salvador, and Curitiba have been trained to perform the procedure, and will soon offer it with the HMV Emphysema Center support.

What is the average life expectancy of patients with this condition?

Survival of patients with emphysema varies on a case-by-case basis, depending on the severity of disease and on the presence or absence of comorbid conditions. At the present time, no data are available that assess the impact of one-way valve treatment on patient survival. The main purpose of this treatment is to improve quality of life.

Is there an age limit for valve placement?

There is no age limit.

What are the prerequisites for one-way valve treatment?

– The patient cannot be a current smoker;
– The patient must be under the care of a physician;
– The patient must have heterogeneous-type emphysema;
– The patient must have the encouragement of his or her family and the support of a qualified psychologist or therapist.

Will the valves remain in the patient’s body permanently or temporarily?

Valves can usually stay in the patient’s body for the rest of his or her life. However, should any issues arise, they can easily be removed or replaced.