1. Retrospective comparison of long-term functionality and revision rate of two different shunt valves in pediatric and adult patients.
- Author
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Busse LC, Dubinski D, Gessler F, Dinc N, Konczalla J, Czabanka M, Senft C, Freiman TM, and Baumgarten P
- Subjects
- Child, Humans, Male, Adult, Female, Retrospective Studies, Ventriculoperitoneal Shunt adverse effects, Ventriculoperitoneal Shunt methods, Cerebrospinal Fluid Shunts adverse effects, Prostheses and Implants adverse effects, Reoperation adverse effects, Hydrocephalus surgery
- Abstract
Purpose: The most frequent therapy of hydrocephalus is implantation of ventriculoperitoneal shunts for diverting cerebrospinal into the peritoneal cavity. We compared two adjustable valves, proGAV and proGAV 2.0, for complications resulting in revision surgery., Methods: Four hundred patients undergoing primary shunt implantation between 2014 and 2020 were analyzed for overall revision rate, 1-year revision rate, and revision-free survival observing patient age, sex, etiology of hydrocephalus, implantation site, prior diversion of cerebrospinal fluid, and cause of revision., Results: All data were available of all 400 patients (female/male 208/192). Overall, 99 patients underwent revision surgery after primary implantation. proGAV valve was implanted in 283 patients, and proGAV 2.0 valves were implanted in 117 patients. There was no significant difference between the two shunt valves concerning revision rate (p = 0.8069), 1-year revision rate (p = 0.9077), revision-free survival (p = 0.6921), and overall survival (p = 0.3232). Regarding 1-year revision rate, we observed no significant difference between the two shunt valves in pediatric patients (40.7% vs 27.6%; p = 0.2247). Revision operation had to be performed more frequently in pediatric patients (46.6% vs 24.8%; p = 0.0093) with a significant higher number of total revisions with proGAV than proGAV 2.0 (33 of 59 implanted shunts [55.9%] vs. 8 of 29 implanted shunts [27.6%]; p = 0.0110) most likely due to longer follow-up in the proGAV-group. For this reason, we clearly put emphasis on analyzing results regarding 1-year revision rate., Conclusion: According to the target variables we analyzed, aside from lifetime revision rate in pediatric patients, there is no significant difference between the two shunt valves., (© 2023. The Author(s).)
- Published
- 2023
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