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Background and objective <p>To assess whether switching valve type or valve brand during shunt revision affects clinical outcomes in pediatric patients with hydrocephalus.</p> Methods <p>Patients at two centers who were younger than 26&#xa0;years of age, underwent a cerebrospinal fluid (CSF) shunt revision involving a valve change, were alive at discharge, and had at least one documented clinical follow-up within 30&#xa0;days were retrospectively reviewed. Patients who were implanted with a different valve type (fixed vs programmable) or brand during the shunt revision were compared to those who maintained the same valve type or brand. The rates of shunt obstruction, infection, overdrainage, reoperation, readmission, and other complications were analyzed.</p> Results <p>Fifty-five patients undergoing 67 shunt revisions involving the valve met the inclusion criteria. Short-term (30-day) complication profiles were similar (<i>p</i> = 0.626) when the valve was replaced with another valve of the same type (<i>n</i> = 31) versus when a different type was implanted (<i>n</i> = 36). Among patients for whom the same valve type was maintained, there were no significant differences in postoperative complications when the fixed-pressure valve brand was changed (<i>n</i> = 7) compared to when the same brand was replaced (<i>n</i> = 12) (<i>p</i> = 0.678). Changing the programmable valve brand (<i>n</i> = 6) resulted in a significantly lower rate of complications (<i>p</i> = 0.025), specifically fewer frequent shunt obstructions (<i>p</i> = 0.025), compared to when the same programmable valve brand was replaced (<i>n</i> = 11).</p> Conclusion <p>In this two-center cohort of shunt revisions involving the valve, changing the valve type or brand was not associated with differences in early (30-day) complication rates. A significant trend toward fewer complications after changing the programmable valve brand was observed in a small subgroup and should be interpreted as hypothesis-generating. Larger, longer-term studies are needed to determine the impact of valve choice on shunt survival and long-term outcomes.</p>

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Short-term clinical outcomes of changing CSF shunt valve type or shunt valve brand in revision surgeries for the management of pediatric hydrocephalus

  • 期刊论文

  • 发表日期：

    2026年2月12日

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  • Kishore Balasubramanian,
  • David Barkyoumb,
  • Taylor G. Burch,
  • Nicholas Sader,
  • Michael J. Feldman,
  • Ira Bowen,
  • Karl Balsara,
  • Michael E. Omini,
  • David S. Hersh,
  • Andrew Jea

摘要

Background and objective

To assess whether switching valve type or valve brand during shunt revision affects clinical outcomes in pediatric patients with hydrocephalus.

Methods

Patients at two centers who were younger than 26 years of age, underwent a cerebrospinal fluid (CSF) shunt revision involving a valve change, were alive at discharge, and had at least one documented clinical follow-up within 30 days were retrospectively reviewed. Patients who were implanted with a different valve type (fixed vs programmable) or brand during the shunt revision were compared to those who maintained the same valve type or brand. The rates of shunt obstruction, infection, overdrainage, reoperation, readmission, and other complications were analyzed.

Results

Fifty-five patients undergoing 67 shunt revisions involving the valve met the inclusion criteria. Short-term (30-day) complication profiles were similar (p = 0.626) when the valve was replaced with another valve of the same type (n = 31) versus when a different type was implanted (n = 36). Among patients for whom the same valve type was maintained, there were no significant differences in postoperative complications when the fixed-pressure valve brand was changed (n = 7) compared to when the same brand was replaced (n = 12) (p = 0.678). Changing the programmable valve brand (n = 6) resulted in a significantly lower rate of complications (p = 0.025), specifically fewer frequent shunt obstructions (p = 0.025), compared to when the same programmable valve brand was replaced (n = 11).

Conclusion

In this two-center cohort of shunt revisions involving the valve, changing the valve type or brand was not associated with differences in early (30-day) complication rates. A significant trend toward fewer complications after changing the programmable valve brand was observed in a small subgroup and should be interpreted as hypothesis-generating. Larger, longer-term studies are needed to determine the impact of valve choice on shunt survival and long-term outcomes.