gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Fixed-pressure gravity-assisted valves and adjustable differential pressure valves in the treatment of pediatric hydrocephalus – a single center study of valve performance in the clinical setting

Meeting Abstract

  • Thomas Beez - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • Sevgi Sarikaya-Seiwert - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • Lina Bellstädt - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • Mario Mühmer - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • Hans-Jakob Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMI.02.04

doi: 10.3205/13dgnc295, urn:nbn:de:0183-13dgnc2951

Published: May 21, 2013

© 2013 Beez 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: Previous studies have established risk factors for ventriculoperitoneal shunt failure in children. However, the role of valve type as a determinant of complications and outcome remains unclear. The aim of this study was to compare the fixed-pressure paediGAV and the programmable Codman Hakim valves in the clinical setting.

Method: We conducted a retrospective review of patients younger than 16 years who underwent primary implantation of a ventriculoperitoneal shunt with either valve type at our institution between January 2005 and December 2010. Shunt survival analyses were performed to identify variables associated with risk of shunt failure.

Results: In a population of 102 patients, 44 received a paediGAV and 29 a Codman Hakim valve. In the paediGAV cohort, 50% reached the endpoint of shunt failure with a mean time of 7 months. In the Codman Hakim cohort 55% experienced shunt failure with a mean time of 8 months. There were no significant differences between both cohorts regarding reason for shunt failure, i.e. mechanical (64% vs. 59%), infectious (27% vs. 24%) or functional (9% vs. 12%). The latter category comprised 2 cases of symptomatic overdrainage requiring surgery in each cohort. To account for imbalances between cohorts, stratified analyses were performed, which identified posthemorrhagic hydrocephalus as a risk factor for shunt failure (n=0.0017). Young age at implantation showed a trend towards higher rate of subsequent failure.

Conclusions: This study confirmed some important risk factors for shunt failure in children. Despite certain limitations and biases, similar findings for both valves examined in the clinical setting were obtained. Overdrainage occurred at similar rates in both cohorts. Thus, valve type does not seem to influence risk of shunt failure. Prospective, randomized and controlled trials are required to validate these results.