more protection against over-drainage complications due to position-dependent function and infinitely variable pressure setting from 0-20 cmH2O
MRI compatible up to 3 Tesla: no X-ray control after MRI necessary, no additional radiation exposure for the patient
"Active-Lock" mechanism: protected against unintentional adjustment by means of exposure to magnets found in daily life, such as those used in smartphones, toys, induction cookers or safety barriers at the airport
"Soft Touch" instruments with enhanced magnetic force: intuitive, safe and comfortable adjustment
Precise precision mechanics
Robust and durable due to the use of titanium
Improvement of the X-ray recognition in the Scout View
The proGAV 2.0 is a position-dependent hydrocephalus valve. It consists of an adjustable differential pressure unit and a gravitational unit, such as the SA 2.0 (see Fig.). This means that it can be optimally adapted to the different pressure conditions in the lying and standing position, thus enabling the patient to achieve the best possible pressure conditions in every position.
In the horizontal position, the gravitational unit is completely open and provides no flow resistance. Under these circumstances, the opening pressure of the proGAV 2.0 is solely controlled by the adjustable unit. The opening pressure setting is determined by the clinical needs of the patient. The range of the adjustable unit is defined from 0 to 20 cmH2O. As long as the IVP (intraventricular pressure) is under the defined opening pressure the adjustable unit is closed and the CSF-drainage is prevented. If the patient's IVP increases and and rises above the efined opening pressure, the spring pressure of the ball-cone is exceeded and the sealing ball moves away from the cone. Now the proGAV 2.0 is open and CSF is drained.
In the vertical position, the gravitational and the adjustable unit operate collectively. As soon as the patient moves into an upright position, the gravitational unit closes and therefore the total opening pressure of the proGAV is significantly increased. The flow of CSF is blocked until the sum of the intraventricular and hydrostatic pressures exeeds the total opening pressure of the proGAV. In this case the gravitational unit opens and the drainage of CSF is possible. The opening pressure of the gravitational unit increases steadily as the patient moves to the upright position. This provides effective protection against over-drainage.
The set pressure level of the proGAV 2.0 can be reliably checked at any time without additional X-ray examination with the proGAV 2.0 compass.
For identification in the X-ray image we recommend the use of the MIETHKE App. Here the valve can be individually adjusted according to the X-ray image and a template can be used to reliably read off which pressure level the proGAV 2.0 represents in the X-ray image (in the picture on the right: 15cmH2O).
In order to avoid reading the pressure level laterally reversed, the valve is marked on one side with a valve marking that is visible in black in the X-ray image - in a top view of the implanted valve the recess is visible on the right side.
The selection of the appropriate pressure setting of the proGAV 2.0 depends on several factors, including the patient's age, degree of activity, height and stature. For further information on pressure stage setting, please refer to our recommendation of pressure levels.
MIETHKE APP - UNDERSTANDING VALVES easily
The MIETHKE App shows clearly and quickly understandable how our valves work:
+ Influence of the body position on the opening pressure: The motion sensor of the smartphone simulates the body position of the patient: upright - inclined - lying.
+ Pressure stage recognition in the X-ray image: Every set or preset pressure stage is shown here and can be easily recognized by means of templates.
+ Simulation of adjustability: Valves can be easily adjusted with the finger and thus help to understand what is happening inside the valve.
+ View into the inside of MIETHKE valves: All valves allow a view of their construction and thus the influence of the cerebrospinal fluid flow on the functioning can be shown in an easily understandable way.
+ free for Apple and Android
B. Braun and MIETHKE - Together for a better life with hydrocephalus
We have a long and intensive partnership with B. Braun in the field of neurosurgery. We are driven by a common vision: to improve the lives of hydrocephalus patients around the world with innovative solutions.
Our partnership is an exciting combination of B. Braun's nearly 180 years of expertise as one of the world's leading medical device and pharmaceutical companies and our agility as an innovative company and technology leader in gravitation-based shunt technology.
Our strong partner in neurosurgery: