Possible Shunt Components; Tube Systems; Surgical Procedure - MIETHKE GAV Mode D'emploi

GAV
The pressure settings given above represent
the pressure drop in the valve at a drainage rate
of 5 ml/h.
The pressure settings selected can be checked
postoperatively on x-ray images, on which the
corresponding coding is visible.
Fig. 5: X-ray image (10/40 cmH

POSSIBLE SHUNT COMPONENTS

The GAV is available with different shunt ac-
cessories. These variants consist of a variety
of components, which are described briefly
below:
The Burrhole Reservoir is positioned in the
cranial burrhole. It allows measuring the in-
traventricular pressure, injecting drugs and
extracting CSF. Its solid titanium base is high-
ly puncture-resistant. All reservoirs are availa-
ble with integrated catheters or connectors.
A special burrhole reservoir is the SPRUNG
RESERVOIR. As additional new feature of this
reservoir CSF can be flushed towards the val-
ve because of a one-way valve in the bottom
of the reservoir. By this mechanism a flow
in the direction of the ventricular catheter is
avoided during the pumping procedure. The
opening pressure of the shunt system is not
increased by the implantation of the SPRUNG
RESERVOIR.
The prechamber is positioned on the craniu m.
It allows measuring the intraventricular pressu-
re, injecting drugs, extracting CSF and perfor-
ming a palpatory ventricle inspection. Its solid
titanium base is highly puncture-resistant.
A puncture of the prechamber or the CONTROL
RESERVOIR should be performed as perpendi-
cular to the reservoir surface as possible with
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2
INSTRUCTIONS FOR USE | EN
a cannula of max. 0,9 mm. 30 times of punc-
tures are able without any restrictions. A special
prechamber is the CONTROL RESERVOIR. As
an additional new feature of this reservoir, CSF
can be flushed towards the valve because of a
one-way valve in the proximal inlet of the reser-
voir. By this mechanism a flow in the direction
of the ventricular catheter is avoided during the
pumping procedure. The opening pressure of
the shunt system is not increased by the im-
plantation of the CONTROL RESERVOIR.
WARNING
Frequent pumping can lead to overdrainage
and thus to unphysiological pressure condi-
tions. The patient should be informed about
the risk.
Due to its tight fit on the ventricular catheter, the
deflector allows choosing the length of catheter
penetrating into the skull prior to implantation.
The ventricular catheter is deflected at a right
angle in the burrhole

TUBE SYSTEMS

The GAV has been designed to ensure the
optimal ventricular pressure. It is available as a
shunt system or as individual valve units with
or without an integrated distal catheter (internal
diameter 1.2 mm, external diameter 2.5 mm).
Individual valve units should be used with ca-
theters of approx. 1.2 mm internal diameter and
approx. 2.5 mm external diameter.
The connector on the valve allows using ca-
theters of 1.0 mm to 1.5 mm internal diameter.
The external diameter of the catheter should
be about double the internal diameter. In any
case, the catheters must be carefully fixed, with
a ligature, to the valve connectors. Kinks in the
catheter have to be avoided.
The provided catheters have virtually no effect
on the Pressure-flow characteristics.

SURGICAL PROCEDURE

Positioning the ventricular catheter
Several surgical techniques are available for po-
sitioning the ventricular catheter. The necessary
skin incision should be carried out, preferably,
in the shape of a lobule pedicled towards the
draining catheter or as a straight skin incision.
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