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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Erste Erfahrungen mit dem proGAV 2.0 Ventil in 51 pädiatrischen Patienten

Meeting Abstract

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  • Stephanie Anetsberger - Neurochirurgische Universitätsklinik Heidelberg, Heidelberg, Deutschland
  • Andreas Unterberg - Neurochirurgische Universitätsklinik Heidelberg, Heidelberg, Deutschland
  • Heidi Bächli - Neurochirurgische Universitätsklinik Heidelberg, Heidelberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 196

doi: 10.3205/17dgnc759, urn:nbn:de:0183-17dgnc7597

Published: June 9, 2017

© 2017 Anetsberger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Hydrocephalus is one of the most common diseases in paediatric neurosurgery. Shunt system design has evolved with the attempt to minimize failure rates and to improve handling. The proGAV 2.0 (Miethke) is the latest, technically improved adjustable valve to prevent overdrainage in shunt dependent hydrocephaly. The differential pressure unit is adjustable. It is to combine with a gravitational unit. There is a tool set to determine, vary and control the opening pressure of the proGAV 2.0- valve, similar to the predecessor, but the latest version also has some different features, like different tool set for adjustment and control. The mechanism to adjust the valve is also different. According to Miethke the valve has improved magnet strength, is MRI compatible up to 3 tesla and now has a new tactile feedback mechanism and “Soft-Touch” instrumentation. The range of the adjustable unit is from 0 to 20 cmH2O. We report our experience with the advanced version of this adjustable valve in 51 consecutive patients.

Methods: From 12/2014-11/2016 we implanted the proGAV 2.0 system in 51 consecutive paediatric patients with hydrocephaly because of tumours, aqueductal stenosis, myelomeningocele (MMC), Dandy-Walker malformation, trauma, intraventricular haemorrhage and hydrocephalus of unknown origin. The 24 female and 27 male patients were between 0 and 23 years old.

Results: There has been no surgical revision because of valve malfunction. There were no spontaneous adjustments detected like in the predecessor and no incidental adjustments during MRI. According to Miethke the opening pressure can be set by pressing lightly with the finger on the adjustable unit but especially in older children or children with thicker skin more than a light pressure is needed to adjust the valve which is connected to more or less discomfort for the patient and make younger children or infants more difficult to handle. A good alternative is to use the proGAV checkmate to adjust the valve in these patients.

Conclusion: The improved proGAV-2.0-valve represents a safe adjustable valve with occasional discomfort during readjustment in patients with thickened skin.