EMPHYSEMA · LUNG VALVE
Karakoca Valve and Lung Valve Treatment: An Incision-Free Option in Emphysema
Prof. Dr. Yalçın Karakoca · Last updated: 25 September 2026
SHORT ANSWER
A lung valve (endobronchial valve) is a small one-way device. It is placed in the airway leading to the part of the lung (lobe) where emphysema is most severe. It is inserted using a thin tube with a camera at its tip (bronchoscope). It lets air out when you breathe out and closes when you breathe in. As a result, the diseased lobe gradually deflates. The healthy parts of the lung and the diaphragm can then work more easily. Shortness of breath may decrease. This treatment is used in suitably selected patients with emphysema. The Karakoca Valve is an original valve design that works on the same principle. It was designed so that it can be removed and reinserted when necessary.
What is the problem in emphysema?
In emphysema, the air sacs are damaged and lose their elasticity. When you breathe out, the air cannot fully escape and builds up in the diseased area (air trapping). This over-inflated area takes up space in the chest cavity and flattens the diaphragm. This makes it harder for the healthy lung to work. The result is shortness of breath, felt at first on exertion and, at a later stage, also at rest. Medicines alone may not solve this problem. Treatments aimed at reducing the size of the diseased part of the lung are then considered. Details: Emphysema.
How does the valve work?
- General anaesthesia or medicines that make you sleepy (deep sedation) are used. The bronchoscope is advanced into the airways and the lobe to be treated is identified.
- One or more valves are placed in the airway leading to this lobe.
- When you breathe out, the valve opens. The built-up air and mucus flow out. When you breathe in, it closes. No new air enters the area.
- The diseased lobe gradually deflates. The healthy parts of the lung expand and the diaphragm works more easily.
- If necessary, the valves can be removed with a bronchoscope. This is the main difference from lung volume reduction surgery.
Lung valve treatment has been examined in international studies using other valves. You will find these studies on the Scientific Publications page.
Features of the Karakoca Valve
- Can be removed and reinserted: It was designed so that, when necessary, it can be removed, cleaned and reinserted. This way, the treatment can be adjusted to suit you over time.
- Controls air flow: The aim is to deflate the treated lobe while preserving the healthy parts.
- A separate device from the balloon: The two devices are intended for different problems. The balloon is used in COPD in which cough and phlegm predominate. The valve, on the other hand, is placed in the part of the lung where air builds up in emphysema. Both may be considered separately in the same patient, for different problems.
Who is it used for?
| Situations in which a valve may be considered | Situations in which a valve may not be suitable |
|---|---|
| Severe emphysema and a marked build-up of air in the lungs | COPD in which cough and phlegm predominate, with little or no emphysema → assessment for balloon treatment |
| Damage concentrated in one lobe of the lung (the lobe to be treated is clearly defined) | No clearly defined lobe to treat; damage spread evenly throughout the lung (except in some cases) |
| No or little air flow between the lobes of the lung | If there is air flow between the lobes: the lobe does not deflate and the valve provides no benefit |
| Shortness of breath that persists despite medicines and pulmonary rehabilitation | Patients whose medical treatment has not yet been optimised |
| Having stopped smoking | An ongoing infection, frequent and severe flare-ups, heart disease that is not under control |
| Patients who are not suitable for lung surgery | Signs of very advanced respiratory failure (assessed on an individual basis) |
How is suitability determined? A breathing test and lung volume measurements are carried out. A thin-section chest CT scan is taken. The CT scan is used to look at the distribution of emphysema and at the lobe to be treated. The condition of the membrane that separates the lobes is also examined. A blood gas test, a 6-minute walk test and a heart check are carried out. If needed, air flow between the lobes is measured with a bronchoscope.
Risks
The most important risk is pneumothorax (air leaking between the membranes that surround the lung). It is not uncommon and mostly occurs in the first few days. This is why you are monitored in hospital for 3–5 days after the procedure. If needed, a chest tube is inserted. There are other risks too. A COPD flare-up, pneumonia, bloodstained phlegm and coughing may occur. The valve may move out of place, become blocked by mucus or need to be removed. There are also risks related to anaesthesia. If there is air flow between the lobes, the treated lobe does not deflate and no benefit is seen.
The treatment process
First, you have a consultation and tests. Your breathing test, lung volumes and a thin-section CT scan are assessed. A blood gas test and a 6-minute walk test are also done. Then the lobe to be treated is identified. If needed, air flow between the lobes is measured with a bronchoscope. The valve is placed under general anaesthesia or with medicines that make you sleepy (deep sedation). The procedure takes 30–60 minutes. You are then monitored in hospital for 3–5 days. At the follow-up visits at 1 month and 3 months, a CT scan is used to check whether the lobe has deflated. Breathing exercises and the exercise programme continue before and after the procedure.
Valve, balloon or another method?
The choice depends on the type of disease. If cough, phlegm and airway narrowing predominate, balloon treatment is considered. If emphysema and air building up in the lungs predominate, a valve is considered. Other methods have also been studied in emphysema patients who are not suitable for a valve. Coils (endobronchial coils) and vapour treatment are examples of these. Comparison: Bronchoscopic COPD treatments.
PRELIMINARY ASSESSMENT
Is it suitable for you?
Book an appointment and bring your breathing test and chest CT scan reports. We decide together at the consultation. If you are coming from outside Istanbul, an online preliminary consultation can be held first.
Please bring: your breathing test, your chest CT scan report and images (CD/USB), your list of medicines and, if you have one, your blood gas test result.
SCIENTIFIC STUDIES
HAVE A QUESTION?
Frequently asked questions
The questions our patients and their relatives ask most often, with answers. We discuss questions about your own situation together at the consultation.
APPOINTMENT
Book an appointment for a preliminary assessment
For an emphysema consultation, bring your thin-section chest CT scan and breathing test results. Appointments: +90 530 337 85 95.
info@yalcinkarakoca.com · Rüzgarlıbahçe Mah. Cumhuriyet Cad. Hasoğlu Plaza Kat:3, Kavacık / Beykoz, İstanbul
This page is for general information purposes. It does not replace a medical examination or diagnosis. Treatment decisions are made during an examination, on an individual basis. In an emergency, call 112.
Medical content review: Prof. Dr. Yalçın Karakoca, Pulmonologist · Last updated: 25 September 2026