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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

First experiences with gravitational valves (proGAV) in the pediatric population

Meeting Abstract

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  • Hans Christoph Ludwig - Neurochirurgische Klinik, Universitätsmedizin Göttingen-UMG, Göttingen, Deutschland
  • Ulrich-Wilhelm Thomale - Arbeitsbereich Pädiatrische Neurochirurgie, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, Deutschland
  • Timo Behm - Neurochirurgische Klinik, Universitätsmedizin Göttingen-UMG, Göttingen, Deutschland
  • Veit Rohde - Neurochirurgische Klinik, Universitätsmedizin Göttingen-UMG, Göttingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1679

doi: 10.3205/10dgnc151, urn:nbn:de:0183-10dgnc1514

Published: September 16, 2010

© 2010 Ludwig et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: CSF overdrainage is the source of complications after ventriculoperitoneal shunting with differential-pressure valves. Recently, an adjustable gravity-assisted valve (proGAV) had been developed to overcome overdrainage problems. Up to now, proGAV only had been used in adult hydrocephalus. Therefore, we are encouraged to report our initial experiences with an adjustable, gravitational valve (proGAV) in childhood hydrocephalus.

Methods: In forty seven children (26 boys, 22 girls, mean age 6.7 years) with hydrocephalus of various origins, 49 proGAV valves were implanted. The proGAV valve consists of a differential pressure unit with adjustable opening pressures and a gravitational unit with a fixed opening pressure. Data collection was prospective.

Results: The mean follow-up period was 27 months (range 3 to 60 months). We did not observe any valve-related complication. Three infections (6.2%) occurred, warranting the removal of the shunt; in 2 children, a proGAV valve was re-implanted In 18 children, the opening pressure was changed at least once during the follow-up period for overdrainage (n=10) and underdrainage (n=8), with substantial clinical improvement in 18 children. Overall, good clinical results were obtained in 44 of the 49 valve placements (91%).

Conclusions: With an overall success rate of 91%, the first experiences with the proGAV valve in childhood hydrocephalus are promising, which justifies proceeding with implantation in the pediatric population.