Possible Shunt Components - MIETHKE proGAV 2.0 Mode D'emploi

proGAV 2.0
4. Verifying the adjustment
After adjusting the valve by using the proGAV
2.0 Adjustment Tool, it must be verified using
the proGAV 2.0 Compass as described in step
2. If the measured pressure now differs from
the intended pressure level, the adjustment
procedure has to be repeated from step 3.
Due to postoperative swelling of the skin the
adjustment of the valve setting may be difficult
within the first few days.
If the pressure configuration of the valve can-
not be determined with complete certainly by
the proGAV 2.0 Compass, the use of imaging
techniques is recommended.
proGAV Check-mate
The proGAV Check-mate is delivered sterile
and is intended to be re-sterilised. It is possi-
ble to change and to verify an applied pres-
sure setting on the valve directly. To verify
the actual pressure setting the proGAV Check-
mate has to be put centrally over the valve.
The proGAV Check-mate will immediately start
to move. If it remains stable, the pressure set-
ting can be read in alignment to the inlet con-
nector. To adjust a new pressure setting, the
proGAV Check-mate has to be placed cen-
trally over the valve. The new pressure set-
ting has to point towards the proximal catheter
(leading to the ventricle). By pressing down
slightly the proGAV Check-mate, the brake of
the valve is decoupled, the rotor turns and
the opening pressure of the proGAV 2.0 is
changed.
Please be aware that the steps for changing
the pressure setting should not be more than
8 cmH O per step.
2
Fig. 14: proGAV Check-mate
INSTRUCTIONS FOR USE | GB
WARNING
Due to magnets inside the proGAV 2.0 Tools,
do not use the proGAV 2.0 Tools nearby pace-
makers. Furthermore do not use the proGAV
2.0 Tools nearby MRI scanner, since there is
a danger of damaging the MRI-scanner.
M.blue plus Instruments
In addition to the described proGAV 2.0
Tools, the M.blue plus Instruments can also
be used for locating, reading and adjusting
the adjustable differential pressure unit of the
proGAV 2.0.
Fig. 15: a) M.blue plus Adjustment Ring
b) M.blue plus Compass

POSSIBLE SHUNT COMPONENTS

The proGAV 2.0 can be ordered as a shunt
system in a range of configurations. The con-
figurations can be combined with the acces-
sories presented in brief below. In each case,
versions for paediatric hydrocephalus and
for normal pressure hydrocephalus (NPH) in
adults are available.
Reservoirs
The use of a reservoir in combination with
shunt systems provides options for the with-
drawal of cerebrospinal fluid, administration of
drugs and pressure control.
Due to the non-return valve of the SPRUNG
RESERVOIR and the CONTROL RESERVOIR,
cerebrospinal fluid can be pumped towards
the valve, thus making it possible to check
the distal part of the drainage system as
well as (proximal) ventricular catheter. Dur-
ing the pump action, access to the ventricular
catheter is closed. The use of reservoirs does
not increase the opening pressure of the shunt
system. A puncture should be performed as
perpendicular as possible to the reservoir sur-
face with a maximum cannula diameter of 0.9
mm. 30 punctures are possible without any
restrictions.
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