Up until a decade ago, doctors had few treatment options for those with advanced lung
disease. Patients who wanted to breathe properly often had no choice but to undergo
invasive, complex surgeries or take slow-acting medications.
More recently, technological breakthroughs offering new ways to see into the lungs’ nooks and crannies have been steadily pushing minimally invasive techniques for lung disease to the forefront, leading to the relatively new field of interventional pulmonology.
The Johns Hopkins Hospital last summer became the first in the region to introduce a dedicated program in this growing arena, recruiting expert David Feller-Kopman from Harvard’s Beth Israel Deaconess Medical Center. When he began his interventional pulmonology fellowship there six years ago, only four such programs existed in the country.
“At Hopkins and throughout the Mid-Atlantic there was a huge need for someone to fill this niche,” says Feller-Kopman. “There are patients here right now who are dying short of breath. One of my goals is to make sure that even if they are dying of metastatic cancer, they are not gasping for air.”
Minimally invasive, ultrasound-guided interventions in the chest cavity range from stents, lasers and other techniques to open airways for patients with recurrent pleural effusions. For nonmalignant central airway obstruction, Feller-Kopman has several technologies to choose from. Additionally,research is being done to offer bronchoscopic treatment for patients with asthma and chronic obstructive pulmonary disease.
Since arriving at Hopkins, Feller-Kopman has been busy. From September through March alone, he performed about 560 procedures on 280 patients. About half of the cases involved central airway obstruction, and the rest resulted
from pleural disease.
Patricia Topp, 48, was recently diagnosed with pulmonary hypertension. “I was on oxygen 24/7 and could barely walk up steps,” says the Baltimore resident. “If I did, I’d have to sit down and catch my breath.” A bronchoscopy revealed that Topp had some web-like tissue growing across her trachea, leaving the amount of useable airway narrowed to the diameter of a juice box straw. In a simple outpatient procedure, Feller-Kopman used an electrocautery knife to destroy the web and expanded a balloon catheter in her airway. The improvement was immediate.
At Hopkins, interventional pulmonology combines the best available modalities across pulmonary medicine, thoracic surgery and otolaryngology. Feller-Kopman plans to grow the service, adding a nurse and eventually bringing in dedicated interventional pulmonology fellows and additional faculty. “My goal is to elevate the field of interventional pulmonology to the same level as interventional cardiology,” says Feller-Kopman, who sits on the board of the American Association of Bronchology. “By collaborating on a local, national and international level, I hope to raise the quality of research and start applying science to this traditionally clinically oriented specialty.”
410-955-3467 to refer a patient.
