Válvula programable de la compañía Medtronic.

Posición 0,5: 1.5

Posición 1.0: 3.5

Posición 1.5: 9.0

Posición 2.0: 14.5

Posición 2.5: 20.0

http://www.medtronic.com/patients/hydrocephalus/device/our-shunts/strata-valves/

Permite un ajuste no invasivo para 5 diferentes perfiles de presión de flujo, que se ajusta con una herramienta magnética.

La apertura es por un mecanismo cono-bola.

Permite la evaluación de la configuración del nivel de rendimiento sin necesidad de utilizar radiografía.

Una revisión retrospectiva de 53 niños con una edad media de 2 años, y 61 válvulas implantadas, mostró eficacia en el tratamiento de la hidrocefalia en los niños.

La tasa de supervivencia en el primer año de 67,2% es comparable a la de un ensayo multicéntrico. De los 30 ajustes terapéuticos destinados durante el período de estudio, 16 (53,3%) dió como resultado una mejoría en los signos o síntomas anormales, obviando la necesidad de cirugía adicional (Ahny col., 2007).

El mecanismo antisifón es de membrana, por lo que es sensible a la presión externa (Czosnyka y col., 2005).

Se puede desconfigurar en Resonancia de 3 Teslas (Inoue y col., 2005).

La presión abdominal afectada la presión de apertura la válvula.

El posicionamiento del sistema antisifón por encima o por debajo de la punta del catéter ventricular dan como resultado presiones de apertura superior e inferior respectivamente.

En el nivel de ajuste más bajo, la presión de apertura es casi 0 mm/Hg y la resistencia está debajo del rango fisiológico normal (Arnell y col., 2009).

Ahn, E. S., M. Bookland, et al. (2007). “The Strata programmable valve for shunt-dependent hydrocephalus: the pediatric experience at a single institution.” Childs Nerv Syst 23(3): 297-303.

Czosnyka, Z. H., M. Czosnyka, et al. (2005). “Evaluation of three new models of hydrocephalus shunts.” Acta Neurochir Suppl 95: 223-7.

Inoue, T., Y. Kuzu, et al. (2005). “Effect of 3-tesla magnetic resonance imaging on various pressure programmable shunt valves.” J Neurosurg 103(2 Suppl): 163-5. Jandial, R., H. E. Aryan, et al. (2004). “Effect of vagus nerve stimulator magnet on programmable shunt settings.” Neurosurgery 55(3): 627-9; discussion 629-30.

Bibliografía recomendada

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2348/Q a presión de 1,5 sin incidencias.