Impact of ventricular-peritoneal shunt valve design on clinical outcome of pediatric patients with hydrocephalus: Lessons learned from randomized controlled trials

Abstract

Hydrocephalus is one of the most common diseases managed by pediatric neurosurgeons. Cerebrospinal fluid (CSF) shunting has been the mainstay of durable treatment for hydrocephalus for many decades. There are two main categories of shunt designs for regulating the extent of CSF diversion: (1) Fixed-parameter valves and (2) adjustable valves. Furthermore, these valves can also function with and without an anti-siphon device. Here, we review randomized controlled trials (RCTs) that examined the impact of these valve designs on the clinical outcome of pediatric patients afflicted with hydrocephalus. All three RCTs suggested no significant differences in clinical outcome as a function of shunt design. Implications of these findings are discussed.

Optimization of number and range of shunt valve performance levels in infant hydrocephalus: a machine learning analysis

“…The specific geometry of shunt valves holds notable potential to influence their fluid resistance, subsequently impacting drainage flow rates within established pressure ranges. However, some literature suggests that this influence might not play a significant role in determining shunt outcomes ( Hoshide et al, 2017 ). It is essential to recognize that while a linear relationship exists between the pressure and flow rate of CSF drainage, this relationship can vary between different valves, exhibiting diverse slopes.…”