Possible Shunt Components; Tube Systems; Implantation - MIETHKE M.blue Instrucciones De Manejo

Fig. 18: 1. proGAV 2.0 scale
Outside: proGAV 2.0 scale of 0 to 20 cmH 2 O (open-
ing pressure of the adjustable differential pressure unit
(proGAV 2.0) in the picture example is 17 cmH 2 O)

POSSIBLE SHUNT COMPONENTS

M.blue can be ordered as a shunt system in a
range of configurations. These configurations
can be combined with the accessories pre-
sented below. In each case, versions for pae-
diatric hydrocephalus and for hydrocephalus
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.
Thanks to an integrated check valve in
the SPRUNG RESERVOIR and the CON-
TROL RESERVOIR, cerebrospinal fluid can be
pumped towards the valve, thus making it pos-
sible to check the distal part of the drainage
system as well as the valve catheter. Dur-
ing the pump action, access to the ventricu-
lar catheter is closed. The use of reservoirs
does not increase the opening pressure of the
shunt system. Puncturing the reservoir should
be performed as perpendicular as possible to
the reservoir surface with a maximum can-
nula diameter of 0.9 mm. A stable titanium
floor prevents the bottom surface from being
pierced. 30 punctures are possible without
any restrictions.
INSTRUCTIONS FOR USE | GB
WARNING
Frequent pumping can result in excessive
drainage and thus lead to pressure condi-
tions outside the normal physiological range.
The patient should be informed about this
risk.
Burrhole deflector
Because of the tight fit on the ventricular
catheter, the burrhole deflector makes it pos-
sible to choose the length of catheter pen-
etrating into the skull prior to implantation.
The ventricular catheter is deflected at a right
angle in the burrhole (see chapter "Implanta-
tion").

TUBE SYSTEMS

M.blue can be ordered as an individual valve
unit or as a shunt system with integrated
catheters (interior diameter 1.2 mm, exterior
diameter 2.5 mm). The supplied catheters do
not fundamentally change the pressure-flow
characteristics. If catheters by other manufac-
turers are used, a tight fit must be ensured. In
any case, catheters have to be carefully fixed
with a ligature to the valve's titanium connec-
tors.

IMPLANTATION

Positioning of the ventricular catheter
Several surgical techniques are available
for positioning the ventricular catheter. The
required skin incision should be made in
form of a lobule pedicled towards the drain-
ing catheter. If a burrhole deflector is used,
the skin incision should not be located right
above the reservoir. To avoid CSF leakage,
care should be taken that the dura opening is
kept as small as possible after applying the
burrhole.
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