ELVR in PH Patients With Severe Emphysema

Inclusion Criteria: * signed patient consent form * men and women \>30 years * Clinically indicated endoscopic lung volume reduction * Pulmonary hypertension according to Group 3.1 of the Dana Point classification * Severe pulmonary emphysema * FEV1 \<45% * RV\> 150% * TLC\> 100% * Maximum of medical therapy according to GOLD * heterogeneous emphysema * Detected in the HR-CT * Confirmation of the heterogeneity of emphysema by computer-assisted quantification (YACTA ®) * stable COPD * No exacerbation in the last 8 weeks * Cortisone dose \<20 mg prednisolone equivalent * Non-or ex-smoker * Nicotine abstinence\> 4 months * Actual CoHb \<2.5% * Diagnosis of pulmonary hypertension (PH), invasively diagnosed by right heart catheterization: * Mean pulmonary arterial pressure (mPAP)\> 25 mmHg * Pulmonary capillary wedge pressure (PCWP) \<15 mmHg * Pulmonary vascular resistance (PVR)\> 320 dyne \* sec \* cm-5 Exclusion Criteria: * PH of Group 1, 2, 4, 5 of the Dana Point Classification * Previous operations * s/p Lung resection (lobectomy / pneumonectomy) * s/p endoscopic lung volume resection * significant bronchiectasis * Sputum volume\> 4 tablespoons / day * Severe cardiac comorbidities: * s/p myocardial infarction in the last 6 weeks * Congestive heart failure * Cardiomyopathy with highly impaired LVF * Clopidogrel in long-term medication * Respiratory insufficiency: PaCO2 mmHg at rest\> 55 * current pregnancy