Post-Operative X-Ray Examination: Identifi Cation Of The Valve Model And Pressure Reading; Patency Test (Post-Operative) - Sophysa POLARIS SPV-140 Gebrauchsanweisung

P :
RECAUTION
D
O NOT IMPLANT THE VALVE WITHOUT SUTURING IT TO THE UNDERLYING TISSUES BY ITS TWO
CONNECTORS OR BY THE SUTURE HOLES PROVIDED FOR THIS
I
F THE SYSTEM MIGRATES THE DRAINAGE MAY STOP AND OTHER COMPLICATIONS ENSUE
W :
ARNING
B
EFORE SUTURING THE VALVE TO THE UNDERLYING TISSUES
.
FACE OF THE VALVE IS VISIBLE
I
F THE ARROW IS NOT VISIBLE THIS MEANS THAT THE VALVE HAS BEEN IMPLANTED THE WRONG WAY
( – ). I ,
UP UPSIDE DOWN N THIS CASE IT WILL BE IMPOSSIBLE TO ADJUST THE VALVE AND DIRECT
C
READING WITH THE OMPASS WILL BE REVERSED
(N .1). T
A VALVE SET TO A LOW POSITION O
( - - ).
OVER OR UNDER DRAINAGE
Case of a valve preconnected to a SiphonX® gravitational anti-siphon device
To prevent any risk of introducing an air bubble, it is recommended that the
"Valve + SiphonX®" assembly be left to fi ll directly with the patient's CSF. For this,
make sure it is kept horizontal. In the majority of cases the "valve + anti-siphon
device" assembly fi lls immediately.
P :
RECAUTION
F P ®
OR OPTIMUM OPERATION OF A OLARIS VALVE WITH A PRE
- ,
ANTI SIPHON DEVICE MAKE SURE THE ASSEMBLY IS POSITIONED PARALLEL TO THE AXIS OF THE BODY
.
OF THE PATIENT
Peritoneal Catheter
- Make a short peritoneal incision in the peri-umbilical region.
- Tunnel the distal catheter.
- Connect the proximal end of the catheter to the valve outlet connector
and ligate it delicately.
- Check the fl ow of CSF.
- Adapt the length of the catheter.
- Bury the distal end of the catheter in the peritoneal cavity.
P :
RECAUTION
D ,
UE TO THE FRAGILITY OF THE SILICONE USING METALLIC FORCEPS FOR INSERTING CATHETERS AND FOR
LIGATING THEM ONTO CONNECTORS IS NOT RECOMMENDED
.
OR PIERCING THE CATHETERS
Post-operative X-ray examination:
Identifi cation of the Valve Model and Pressure Reading
N :
OTE
D
URING THE RADIOLOGICAL EXAMINATION ORIENTATE THE PATIENT SO THAT THE RAY SOURCE POINTS
. I
PERPENDICULARLY ONTO THE VALVE BODY N THIS WAY IDENTIFYING THE VALVE BY ITS RADIO
.
POINT IS MADE EASY
The radio-opaque points to the left of the inlet connector are used to identify
the pressure range of the valve:
Number of radio-
zero
mmm
opaque points
Maximum
operating pressure 140
(mmH O)
2
N :
OTE
T
HE PRESSURE RANGE OF THE IMPLANTED VALVE IS SHOWN ON THE
.
OF THE VALVE MODEL USED
.
.
,
CHECK THAT THE ARROW ON THE UPPER
, : (N .5)
FOR EXAMPLE A HIGH READING O
HIS COULD CAUSE SERIOUS CLINICAL CONSEQUENCES
- S X®
ATTACHED IPHON GRAVITATIONAL
. T
HIS WOULD CREATE A RISK OF CUTTING
-
OPAQUE
one two three
mml mll lll
200 300 400
P C ,
ATIENT ARD IN THE DESCRIPTION
Figure 15: Radiographic identification of the different models and the correlation with
the pressure range on the Locator.
FOR
It is easy to read the pressures on a radiological image (Figure 16).
Figure 16: Confirmation of the operating pressure (at the top: views of the Polaris®
adjustment kit; at the bottom, radiological views of the valve (SPV model))
Position 1 Position 2
On the Polaris® valve, each of the fi ve valve pressures is located by the position of
the radio-opaque identifi cation point for the corresponding operating pressure.
Locate the valve inlet connector, wider due to the presence of a nut.
The position for the lowest operating pressure (Position No. 1) is the position located
nearest to this connector.
If the right-hand valve rotor micro-magnet is facing the radio-opaque point nearest
the inlet connector, the valve is set at the lowest pressure (Position No. 1).
Then, moving clockwise away from the inlet connector, each of the following radio-
opaque points corresponds to a higher pressure.
So the radio-opaque point furthest away from the valve inlet connector corresponds
to the highest pressure (Position No. 5).

Patency Test (post-operative)

There are two steps for the post-operative test on the patency of the shunt:
1. Testing the patency of the ventricular catheter
N :
OTE
T SPVA (
HIS TEST IS POSSIBLE WITH
. F SPV
MODELS OR THE TYPE MODEL
Pinch the catheter with a fi nger just after the valve outlet connector.
With another fi nger, press the reservoir to make the CSF fl ow back into the ventricular
catheter. A reservoir that cannot be compressed easily or does not fi ll quickly may
indicate there is an obstruction in the ventricular catheter.
2. Patency test downstream of the reservoir
(valve and distal catheter)
N :
OTE
T
HIS CONTROL IS IMPOSSIBLE WITH A
NO ACCESS TO THE VENTRICULAR CATHETER UPSTREAM OF THE RESERVOIR
13
Position 4
Position 3 Position 5
) SPVB (
ANTECHAMBER AND BURR HOLE RESERVOIR
,
A VENTRICULAR CATHETER WITH RESERVOIR MUST BE USED
SPVB ( )
TYPE MODEL BURR HOLE RESERVOIR BECAUSE THERE IS
.
)
TYPE
.