Fluid flow performance of a new siphon-control device for ventricular shunts

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Abstract
Most available cerebrospinal fluid diversion systems utilize differential-pressure valves that often induce overshunting, resulting in complications due to the siphoning of fluid from the ventricular system when the patient is in the erect position. A new siphon-control device (SCD) was tested alone and in combination with four types of differential-pressure valves with low, medium, and high opening pressures (namely PS Medical, Heyer-Schulte, Cordis-Hakim, and Codman valves). The valve inlet and outlet pressures were measured at several fluid inflow rates between 2.0 and 50.0 ml/hr. Inlet pressure and valve resistance were determined when the outlet pressures of the differential-pressure valve or SCD were varied between 0 and -60 cm H2O. Of the differential-pressures valves tested, none provided protection against siphoning without the distal connection of the SCD. The SCD allowed all differential-pressure valves tested to maintain atmospheric pressure regardless of the outlet pressure. The SCD performs in a manner similar to the older anti-siphon device, but with some improvements in design and construction. The results of this investigation suggest that the increased resistance due to the inline SCD is not functionally significant when added to the conventional valve systems with low opening pressure.