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The puncturable ventriculo-atrial shunt for hydrocephalus

A preliminary report

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Summary

The diagnosis and treatment of malfunctions of sixteen implanted Heyer-Pudenz ventriculo-atrial shunts have been aided by the use of the new puncturable dome flushing device.

Principal Clinical Uses

  1. (1)

    Pressure readings.

  2. (2)

    Testing flushing device diaphragm valve rupture.

  3. (3)

    Localization of cardiac valve position.

  4. (4)

    Ventricular fluid cultures.

  5. (5)

    RISA studies of function of separate components of shunt.

  6. (6)

    Testing ventricular catheter patency and diaphragm valve competence in shunt with total occlusion of the cardiac segment.

Therapeutic Uses

  1. (7)

    Returning the flushing device dome to normal configuration by saline injection.

  2. (8)

    Emergency ventricular drainage.

It may be that other uses for the puncturable feature will be conceived as our experience with the ventriculo-atrial shunt and its complications becomes broader.

Zusammenfassung

Zusammenfassung

Die Diagnose und Behandlung von Störungen der Funktion von 16 eingebauten Heyer-Pudenz-Ventilen konnte durch den Gebrauch eines neuen punktierbaren Flüssigkeitsreservoirs erleichtert werden. Die wesentlichen klinischen Anwendungen sind:

  1. 1.

    Druckmessungen.

  2. 2.

    Nachweis einer Ruptur der Pumpenmembran.

  3. 3.

    Lokalisation der intrakardialen Lage des Ventils.

  4. 4.

    Bakteriologische Untersuchungen des Ventrikelliquors.

  5. 5.

    RISA-Untersuchungen der Funktion der einzelnen Komponenten des Shunts.

  6. 6.

    Prüfung der Durchgängigkeit des Vontrikelkatheters und der Funktion der Pumpenmembran bei solchen Shunts, bei denen das kardiale Segment vollständig verschlossen ist.

Folgende therapeutische Anwendungen sind möglich

  1. 7.

    Wiederherstellung der normalen Durchgängigkeit des Ventilsystems durch Injektion von Kochsalzlösung.

  2. 8.

    Ventrikeldrainage in Notfällen.

Es ist zu erwarten, daß sich noch weitere Anwendungsmöglichkeiten für das punktierbare Flüssigkeitsreservoir ergeben werden, wenn die Erfahrungen mit dem ventrikulo-atrialen Shunt und seinen Komplikationen größer wird.

Résumé

Résumé

Le diagnostic et le traitement des mauvais fonctionnements de 16 shunts ventriculo atriaux de Heyer-Pudenz qui avaient été mis en place, ont été facilités par l'utilisation d'un nouveau dispositif de déplétion en capsule ponctionnable.

Principales applications cliniques:

  1. 1.

    Lectures de la pression.

  2. 2.

    Test de la valve diaphragme de rupture du dispositif de déplétion.

  3. 3.

    Localisation de la position de la valve cardiaque.

  4. 4.

    Cultures du liquide ventriculaire.

  5. 5.

    Etudes de RISA du fonctionnement des différents segments du shunt pris séparément.

  6. 6.

    Test du fonctionnement du cathéter ventriculaire, et du fonctionnement de la valve diaphragme dans le shunt, par l'occlusion totale du segment cardiaque.

Applications thérapeutiques

  1. 7.

    Remettre le dispositif de déplétion en capsule à la configuration normale par injection saline.

  2. 8.

    Drainage ventriculaire d'urgence.

On espère que d'autres utilisations du dispositif ponctionnable seront conçues comme notre expérience avec le shunt ventriculo-atrial et leurs applications plus larges.

Riassunto

Riassunto

La diagnosi e la correzione del cattivo funzionamento di sedici derivazioni ventricolo-atriali con la valvola di Heyer-Pundez sono state rese possibili dall'uso di un nuovo accessorio, che puó essere punto in situ.

I principali usi di questo accessorio sono:

  1. 1.

    Registrazioni di pressione.

  2. 2.

    Prova del funzionamento della valvola.

  3. 3.

    Localizzazione della posizione della valvola cardiaca.

  4. 4.

    Culture di liquor ventricolare.

  5. 5.

    Studi con RISA del funzionamento delle varie parti della valvola.

  6. 6.

    Determinazione della pervietà del catetere ventricolare connesso con un segmento cardiaco completamente occluso.

Usi terapeutici:

  1. 7.

    Sblocco della valvola con iniezione di soluzione fisiologica.

  2. 8.

    Drenaggio ventricolare di emergenza.

Altri usi di questo importante accessorio saranno certamente concepiti dagli Autori quando sarà più ampia l'esperienza di derivazioni ventricoloatriali e delle loro complicanze.

Resumen

Resumen

El diagnóstico y el tratamiento del mal funcionamiento de 16 válvulas ventriculo-atriales de Heyer-Pudenz, que habían sido colocadas, ha sido facilitado con el empleo de un nuevo dispositivo de deplección en forma de cápsula puncionable.

Principales aplicaciones clínicas:

  1. 1.

    Medida de la presión.

  2. 2.

    Test de la válvula diafragma de ruptura del dispositivo de deplección.

  3. 3.

    Localización de la situación de la válvula cardiaca.

  4. 4.

    Estudios del líquido ventricular.

  5. 5.

    Estudios con RISA del funcionamiento de los diferentes segmentos del shunt tornados separadamente.

  6. 6.

    Test de funcionamiento del catéter ventricular y del funcionamiento de la válvula diafragma en el shunt por la oclusión total del segmento cardiaco.

Aplicaciones terapéuticas:

  1. 7.

    Reponer el dispositivo de deplección normalmente en la cápsula mediante inyección salina.

  2. 8.

    Drenaje ventricular de urgencia.

Se espera que el dispositivo puncionable pueda tener otras aplicaciones, además de nuestra experiencia con las válvulas ventriculo-atriales.

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Authors
  1. C. P. Bondurant Jr.
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  2. M. C. Overton III
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  3. J. E. Coe
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Bondurant, C.P., Overton, M.C. & Coe, J.E. The puncturable ventriculo-atrial shunt for hydrocephalus. Acta neurochir 13, 544–555 (1965). https://doi.org/10.1007/BF02074433

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