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The aim of this retrospective analysis was to evaluate the response to therapy and the complication rate at 90 days (90d-FU) after combined RUL-ML valve implantation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective, monocentric study included all patients from the Thoraxklinik Heidelberg who underwent RUL-ML valve treatment between 2012 and 2023 with available follow-up data. Quantitative chest imaging, lung function, 6-minute walking distance (6-MWD), complications and indications for re-bronchoscopies until 90d-FU were analysed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>28 patients underwent combined RUL-ML valve treatment, predominantly sequentially (92.86%, <jats:italic>n<\/jats:italic>\u2009=\u200926\/28). Neither lung function nor 6MWD improved significantly in the overall cohort. However, in the subgroup with heterogeneous emphysema (71.4%, <jats:italic>n<\/jats:italic>\u2009=\u200920\/28), FEV1 (\u0394\u2009=\u2009116.00 mL\u2009\u00b1\u2009195.77 mL, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and 6-MWD (\u0394\u2009=\u200950.23\u2009\u00b1\u200969.10\u00a0m, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) increased significantly at 90d-FU. Consistent with this, the baseline difference in emphysema volume between the RUL\u2009+\u2009ML and the right lower lobe correlated significantly with the increase in FEV1 at 90d-FU (<jats:italic>R<\/jats:italic>\u2009=\u20090.74, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Pneumothorax occurred in 5 cases in 4 patients (14.3%) following ML treatment. Severe pneumonia and\/or COPD exacerbations occurred in 32.1% (9\/28) of patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Although only studied in a small cohort, our data suggest that combined RUL and ML valve implantation appears to be a promising interventional treatment strategy in patients with severe heterogenous RUL and ML emphysema.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12931-024-03069-6","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T17:50:11Z","timestamp":1736185811000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcome and safety 90 days after combined airway valve treatment of the right upper and middle lobes in patients with severe pulmonary emphysema"],"prefix":"10.1186","volume":"26","author":[{"given":"A. 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For this, ethical approval was obtained from the ethics committee of the University of Heidelberg (S-621\/2023).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The present manuscript was not supported by any external donors. Irrespective of this, the following grants or fees were paid to the individual authors in the last 36 months:ASD received a grant and charges for registry analysis by the German CF Foundation. KK received consulting fees from Cook Medical as well as presentation fees from AstraZeneca, Berlin Chemie, Boston Scientific and Olympus and received travel grants from AstraZeneca. FT received speaker honoraria from Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Grifols, Novartis, CSL Behring, Streamed up and RG Gesellschaft f\u00fcr Information und Organisation mbH. JMB received grants of the Thoraxstiftung Heidelberg and the Beatrice von Hardenberg Stiftung, consulting fees from Boehringer Ingelheim and Intuitive Surgical Inc as well as speaker fees from Boehringer Ingelheim, Astra Zeneca, Streamed up, Berlin Chemie, PulmonX and Olympus. RE received honoraria from Olympus and Pulmonx for lectures and educational activities. FH received speaker fees from Olympus and Pulmonx.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable. There are no images or other personal or clinical details of participants included in this manuscript that might compromise anonymity.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"4"}}