Selection Of The Appropriate Pressure Level; Reading The Pressure Setting From An X-Ray Image; Using The Instruments - MIETHKE proGAV 2.0 Mode D'emploi

EN | INSTRUCTIONS FOR USE
SELECTION OF THE APPROPRIATE
PRESSURE LEVEL
Horizontal position
The opening pressure for the horizontal body
position is achieved using the adjustable differ-
ential pressure unit. Here, the pressure stage
should be set in accordance with the clinical
picture and indications. Depending on the clin-
ical picture and age of the patient, the open-
ing pressure for this position can be selected
between pressure levels 0 and 20 cmH O.
Vertical position
The proGAV 2.0 opening pressure for the
vertical body position is calculated from
the sum of the opening pressure of the
adjustable differential pressure unit and the
gravitational unit. Patient size, activity level
and potentially increased abdominal pressure
(obesity) should be taken into account in
selecting the opening pressure for this posi-
tion (see pressure level recommendations at
https://www.miethke.com/downloads/).
READING THE PRESSURE SETTING
FROM AN X-RAY IMAGE
The set pressure level of the proGAV 2.0 should
always be checked using the proGAV 2.0 Com-
pass, but it can also be checked using an x-ray
image. The rotor setting is decisive in this case.
The four magnets in the rotor can be seen on
the x-ray image as white points and are located
opposite each other in pairs. Two additional
burrholes (right and left next to the magnet
pairs) on one side of the rotor can be used as
orientation. They can be seen as black points
on the X-ray image. This side can be designated
as the rotor rear side. The two front magnets are
opposite. The space between these two mag-
nets can be considered as the triangle apex.
The pressure level can be read o using the ori-
entation of this intermediate space. The triangle
apex can take up any position except the space
labelled as a non-adjustable area in fig. 5. This
means that the opening pressure of the proGAV
2.0 can be infi nitely variably adjusted from 0
up to 20 cmH O. To ensure that the pressure
2
stage is not read o as a mirror image, the valve
is provided with a valve marking on one side
which is visible as black in the X-ray image - on
a plan view of the implanted valve as in fig. 6
the recess on the right-hand side is visible.
18
Fig. 5: Schematic representation of rotor in X-ray image
1) Admittance markings 2) Valve marking
3) Non-adjustable range 4) Triangle apex
Fig. 6: X-ray image of an adjustable differential pressure
unit, setting 14 cmH O
2
The pressure levels can be identified by coding
in the X-ray image. The following pressure levels
are possible for the gravitational unit:
Opening Coding
Pressure
10 cmH O
2
15 cmH O
2
20 cmH O
2
25 cmH O
2
30 cmH O
2
35 cmH O
2

USING THE INSTRUMENTS

With the proGAV 2.0 Tool Set the selected
opening pressure of the proGAV 2.0 can be
determined, varied and controlled.
The proGAV 2.0 Compass is used to locate and
verify the DP adjustable unit.
proGAV ® 2.0