Article
First experiences with gravitational valves (proGAV) in the pediatric population
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Published: | September 16, 2010 |
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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.