First experiences with an adjustable gravitational valve in childhood hydrocephalus

Clinical article

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The goal of this report was to describe the authors' initial experiences with an adjustable gravity-assisted valve (GAV) called the ProGAV in treating childhood hydrocephalus.


The ProGAV was implanted in 53 children (29 boys and 24 girls, median age 7.3 years) with hydrocephalus of various origins. The ProGAV consists of a differential-pressure unit with adjustable opening pressures and a gravitational unit with a fixed opening pressure.


The mean follow-up period was 15.2 months (range 6–44 months). The authors did not observe any valve-related complications. Four infections (7.5%) occurred, warranting the removal of the shunt. In 19 children, the opening pressure was changed at least once during the follow-up period, for underdrainage in 10, overdrainage in 8, and shunt weaning in 1, with substantial clinical improvement in 18 children. Overall, good clinical results were obtained in 47 (88.7%) of the 53 valve placements.


With an overall success rate of 88.7%, the first experiences with the ProGAV in childhood hydrocephalus are promising and justify its further use in the pediatric population.

Abbreviations used in this paper: CSF = cerebrospinal fluid; DP = differential pressure; FOHR = frontooccipital horn ratio; GAV = gravity-assisted valve.

Article Information

Address correspondence to: Veit Rohde, M.D., Department of Neurosurgery, Georg-August University Goettingen, Robert-Koch-Strasse 40, 37075 Goettingen, Germany. email:

© AANS, except where prohibited by US copyright law.



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    Kaplan-Meier curves of valve survival and surgery-free shunt survival after a mean follow-up of 15.2 months and a maximum follow-up of 44 months.



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