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This single-center retrospective study identified “beyond-criteria” patients meeting two or more defined clinical thresholds and compared their 3-, 6-, and 12-month complications and functional outcomes with standard-criteria patients.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/expanding-lung-volume-reduction-surgery-indications-outcomes-in-patients-beyond-conventional-national-emphysema-treatment-trial-criteria/459117/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/expanding-lung-volume-reduction-surgery-indications-outcomes-in-patients-beyond-conventional-national-emphysema-treatment-trial-criteria/459117.png","ImageObject",300,407,{"name":92,"@type":93},"dawugda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the study’s primary objective regarding LVRS indications?","Question",{"text":112,"@type":113},"To identify patients undergoing LVRS beyond conventional NETT selection criteria and compare their outcomes with those meeting standard criteria.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were “beyond-criteria” patients defined in the study?",{"text":117,"@type":113},"Patients were classified as beyond-criteria if they met two or more thresholds including age ≥75 years, BMI \u003C18.5 kg/m², FEV1 \u003C20% predicted, DLCO \u003C20% predicted, 6-minute walk distance \u003C140 m, homogeneous emphysema, sPAP >35 mmHg, or prior thoracic interventions.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main findings on complications and functional outcomes?",{"text":121,"@type":113},"Complication rates were comparable between beyond-criteria and standard-criteria groups, and functional and quality-of-life measures improved in both groups.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},459117,1792176863,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},3985747870947,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Interdisciplinary CardioVascular and Thoracic Surgery 2025, 40(12), ivaf274 ORIGINAL ARTICLE  \n[https://doi.org/10.1093/icvts/ivaf274](https://doi.org/10.1093/icvts/ivaf274) Advance Access publication 18 November 2025  \nCite this article as: Vandervelde CM, Meyers A, David A, Bouneb S, Everaerts S, Janssens W et al. Expanding Lung Volume Reduction Surgery Indications: Outcomesin Patients Beyond Conventional National Emphysema Treatment Trial Criteria. Interdiscip CardioVasc Thorac Surg 2025; doi:10.1093/icvts/ivaf274.  \nExpanding Lung Volume Reduction Surgery Indications: Outcomes in Patients Beyond Conventional National Emphysema Treatment  \nTrial Criteria  \nChristelle M. Vandervelde 1,2; Anthony Meyers1; Anaïs David1; Sofian Bouneb 3,4; Stephanie Everaerts 2,5; Wim Janssens2,5; Walter Weder6; LaurensJ. Ceulemans 􀀃 ,1,2  \n1 Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium  \n2 Department of Chronic Diseases and Metabolism Laboratory of Pneumology and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium 3 Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium  \n4 Department of Cardiovascular Sciences, Division of Anaesthesiology and Algology, KU Leuven, Leuven, Belgium  \n5 Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium 6 Department of Thoracic Surgery, Klinik Bethanien, Zurich, Switzerland  \n􀀃 Corresponding author. Department of Thoracic Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium ([laurens.ceulemans@uzleuven.be](laurens.ceulemans@uzleuven.be)).  \nReceived: October 15, 2025; Accepted: November 5, 2025  \nGraphical abstract  \nPoster Presentation: The abstract of this manuscript was presented (poster) at the ESTS Annual Meeting 2025.  \nTHORACIC NON-ONCOLOGY  \n© The Author(s) 2025. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution License ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.  \n2 Interdisciplinary CardioVascular and Thoracic Surgery, 2025, Volume 40, Issue 12 Abstract  \nObjectives: Lung volume reduction surgery (LVRS) is guided by strict selection criteria from the National Emphysema Treatment Trial (NETT) to minimize risk and optimize outcomes. However, emerging evidence suggests that rigid cutoffs may exclude patients who could benefit. This study aimed to identify beyond-criteria patients undergoing LVRS and compare their outcomes with standardcriteria patients.  \nMethods: This single-centre retrospective analysis of a prospectively maintained database included all LVRS procedures from August 2019 until November 2024. Patients were classified as beyond-criteria if they met two or more of the following: age ≥ 75 years, body mass index (BMI) \u003C 18.5 kg/m2, forced expiratory volume in 1 second (FEV1) \u003C 20%pred, diffusing capacity for carbon monoxide (DLCO)\u003C 20%pred, 6-minute walk distance (6MWD) \u003C 140 m, homogeneous emphysema, systolic pulmonary arterial pressure (sPAP) > 35 mmHg, or prior thoracic interventions. Complications (Clavien-Dindo) and functional outcomes were assessed at 3, 6, and 12 months.  \nResults: Twenty-one procedures were performed in 18 beyond-criteria patients versus 227 procedures in 191 standard-criteria patients. Among beyond-criteria patients: age ≥ 75 years (n ¼ 3), BMI \u003C 18.5 kg/m2 (n ¼ 10), FEV1 \u003C 20%pred (n ¼ 5), DLCO \u003C 20%pred (n ¼ 1), 6MWD \u003C 140 m (n ¼ 1), homogeneous emphysema (n ¼ 3), sPAP > 35 mmHg (n ¼ 12), and prior thoracic intervention (n ¼ 7). Complication rates were comparable (38% vs. 42%, P ¼ .819 [95% CI, 0.93-1. 10]), as were prolonged air leaks and hospital stay. One 30-day LVRS-related death (0.4%) occurred in the standard group. Functional and q","cbCaisXCVeH8vbbY","https://ap.wps.com/l/cbCaisXCVeH8vbbY","pdf",1349823,"English","# Objectives\n# Methods\n# Results\n# Conclusions\n# Introduction\n# Keywords","[{\"question\":\"What is the study’s primary objective regarding LVRS indications?\",\"answer\":\"To identify patients undergoing LVRS beyond conventional NETT selection criteria and compare their outcomes with those meeting standard criteria.\"},{\"question\":\"How were “beyond-criteria” patients defined in the study?\",\"answer\":\"Patients were classified as beyond-criteria if they met two or more thresholds including age ≥75 years, BMI \\u003c18.5 kg/m², FEV1 \\u003c20% predicted, DLCO \\u003c20% predicted, 6-minute walk distance \\u003c140 m, homogeneous emphysema, sPAP \\u003e35 mmHg, or prior thoracic interventions.\"},{\"question\":\"What were the main findings on complications and functional outcomes?\",\"answer\":\"Complication rates were comparable between beyond-criteria and standard-criteria groups, and functional and quality-of-life measures improved in both groups.\"}]","Expanding Lung Volume Reduction Surgery Indications - Outcomes in Patients Beyond Conventional National Emphysema Treatment Trial Criteria | PDF",1790755228]