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Hospital initiates innovative breakthrough treatment for asthma

5/10/2011 — Yale New Haven Hospital has become the first hospital in Connecticut to perform bronchial thermoplasty, a non-drug procedure for severe persistent asthma in patients 18 years and older whose asthma is not well-controlled with inhaled corticosteroids and long-acting beta-agonists.

Bronchial thermoplasty is performed with a catheter-like device that delivers thermal energy (heat) to the lungs of patients with asthma in order to decrease the amount of smooth muscle in the lungs. The smooth muscles are responsible for bronchoconstriction and asthma symptoms. For this procedure, patients must undergo a bronchoscopy, in which a bronchoscope is inserted into the airways through the nose or mouth. Bronchial thermoplasty allows patients to gain better control of their asthma because the lungs are not able to constrict as much and react as vigorously to asthma triggers.

"This new procedure offers an upgrade for treatment over inhaled drugs or other medications because we are attacking the problem at its very root - the lungs themselves," noted Jonathan Puchalski, MD, attending physician in pulmonary and critical care at YNHH and assistant professor of medicine at Yale School of Medicine (YSM). "This device delivers the thermal energy to the airway wall, in a precisely controlled manner, in order to reduce excessive airway smooth muscle. This decreases the constriction of the airways and reduces the frequency of asthma attacks."

This minimally invasive procedure is performed in three outpatient visits, generally scheduled about three weeks apart, to treat different areas of the lungs. The procedure is performed under moderate sedation or light anesthesia, and the patient typically goes home the same day.

"With this breakthrough treatment, we are confident we will be able to alleviate much of the suffering of our patients with severe asthma," said Geoffrey Chupp, MD, director, Yale Center for Asthma and Airway Disease (YCAAD) and associate professor of medicine at YSM. "In the past, these patients received high doses of medication and continued to suffer from frequent asthma attacks and limitations on routine daily activities, as well as frequent emergency room visits. Bronchial thermoplasty gives new hope to those asthmatic patients and a non-drug option to control their disease."

"We feel that bronchial thermoplasty is expected to fully complement asthma maintenance medications by providing long-lasting asthma control and improving asthma-related quality of life of patients with severe asthma," concluded both Drs. Chupp and Puchalski. "For those with severe asthma, this is a terrific option where medication can fall short."

For more information on bronchial thermoplasty and other asthma research, go to the Yale Center for Asthma and Airway Disease website at and click on "Connect with YCAAD".

Yale School of Medicine is known throughout the world as one of the leading centers for biomedical research, education and advanced health care. Founded in 1810, the School of Medicine has grown to include every modern medical discipline. Its faculty includes some of the world's most respected scholars in medicine, public health and biomedical science.

Yale New Haven Hospital (YNHH), part of Yale New Haven Health, is a nationally recognized, 1,541-bed, not-for-profit hospital serving as the primary teaching hospital for the Yale School of Medicine (YSM). Founded as the fourth voluntary hospital in the U.S. in 1826, today, YNHH has two New Haven-based campuses, and also includes Yale New Haven Children's Hospital, Yale New Haven Psychiatric Hospital and Smilow Cancer Hospital. YNHH has received Magnet designation from the American Nurses Credentialing Center, the nation’s highest honor of nursing excellence. YNHH has a combined medical staff of about 4,500 university and community physicians practicing in more than 100 specialties.