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Shunt failure caused by valve collapse.

T Lundar1, I A Langmoen, K H Hovind

  • 1Department of Neurosurgery, National Hospital, University of Oslo, Oslo, Norway.

Journal of Neurology, Neurosurgery, and Psychiatry
|June 1, 1991
PubMed
Summary
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Mini-Holter valve failure occurred in 6% of pediatric shunt patients due to valve collapse. Replacing with adult Holter valves in infants over one month old resolved this complication.

Area of Science:

  • Neurosurgery
  • Pediatric Surgery
  • Biomedical Engineering

Background:

  • Ventriculoperitoneal (VP) and ventriculoatrial (VA) shunts are crucial for managing hydrocephalus in children.
  • The Mini-Holter valve was a specific type of shunt valve used in pediatric neurosurgery.
  • Shunt malfunction is a significant concern in pediatric hydrocephalus management.

Purpose of the Study:

  • To report the incidence and nature of shunt failure associated with the Mini-Holter valve in pediatric patients.
  • To evaluate the efficacy of switching to the adult Holter valve after Mini-Holter valve complications.

Main Methods:

  • Retrospective review of 179 pediatric patients implanted with Mini-Holter VP or VA shunts over a 10-year period.
  • Analysis of shunt failure events specifically attributed to Mini-Holter valve collapse (intussusception).

Related Experiment Videos

  • Comparison of outcomes after replacing Mini-Holter valves with adult Holter valves in a subsequent cohort.

    • Main Results:

    • Shunt failure due to Mini-Holter valve collapse occurred in 11 out of 179 children (6%), with 13 such events observed.
    • Valve collapse, specifically intussusception, was identified as the cause of failure in all reported cases.
    • All collapsed valves were part of ventriculoperitoneal shunt systems.
    • Following the abandonment of the Mini-Holter valve and implantation of adult Holter valves in children over one month old, no valve breakdowns were reported in 102 children and 200 adults.

    Conclusions:

    • The Mini-Holter valve demonstrated a significant rate of failure due to collapse in pediatric shunt systems.
    • Intussusception of the Mini-Holter valve is a specific mechanism leading to shunt malfunction.
    • Switching to the adult Holter valve appears to be a safe and effective alternative in pediatric patients, eliminating the complication of valve collapse.