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9.2. Functional check
Perform several adjustments on the demonstration valve
supplied with the adjustment kit to make sure the adjustment
kit works properly.
10. Solutions in case of difficult adjustment
The following situations may lead to inaccurate reading of
the pressure by the Compass and/or adjustment difficulties
with the Magnet:
– the patient is in a position that prevents the valve from be-
ing horizontal,
– the Locator is offset from the center of the valve by more
than 2 mm,
– the Locator is poorly oriented in relation to the flow path,
– the base of the Locator and the surface of the valve are
not parallel.
Before doing anything else, check that the Locator is cor-
rectly positioned and oriented above the valve. See Sec-
tion 8.2.3. Positioning the patient (p. 13) and Section 8.2.4.
Positioning the Locator (p. 13).
However, other causes may intervene and cause adjustment
difficulties.
Special procedures, described below, may then be applied
to facilitate adjustment of the valve, possibly using fluoro-
scopic control.
10.1. Backwards and forwards movement of the Mag-
net
Unlocking the mobile micro-magnets within the Polaris valve
may be difficult if the CSF is viscous or contains debris.
In this case, performing multiple backwards and forwards
motions can facilitate the unlocking of the micro-magnets:
1.
Using the Compass, position the Locator above the
valve as described for normal operation.
2.
To avoid losing the reference position, hold the Locator
with one hand until the end of the procedure.
3.
Remove the Compass.
4.
Align the mark on the Magnet on the pressure read to in-
sert the Magnet vertically in the Locator.
5.
Slide the handle of the Magnet back and forth along the
axis of the pressure read.
6.
Recenter the handle of the Magnet.
7.
Turn the Magnet until it reaches the position chosen as
the pressure for the valve to be implanted.
8.
Remove the Magnet vertically to ensure effective re-
locking of the valve rotor in the selected position.
Page 16 of 82
9.
Place the Magnet more than 50 cm from the valve.
10. Insert the Compass fully into the Locator to confirm the
new pressure.
10.2. Stop method
The correct orientation of the Locator in relation to the
valve's flow path is essential for an accurate reading of the
Compass.
Under thick skin, the connectors are sometimes difficult to
locate, which makes it difficult to accurately determine the
optimum orientation of the Locator.
In this case:
– If the current pressure of the valve is known (up to date
Patient Identification Card or recent X-ray), the orientation
of the Locator can be corrected with the Compass during
the reading, by turning the Locator-Compass assembly
slightly so as to align the Compass needle on the known
pressure of the valve.
– If the current pressure is not known with certainty, only the
stop method described below will ensure correct reading.
This entails adjusting the valve to one of its end positions
(or stops). This makes it possible to correct the orientation
during the reinsertion of the Compass.
NOTE
The maximum position is usually selected as the stop
so as to favor the reduction of drainage during han-
dling.
Stop method
Following the initial reading, the Locator is centered and the
Compass needle indicates a pressure.
Follow the steps described below to ensure the Locator cor-
rect orientation:
1.
Without moving the Locator:
a.
remove the Compass,
b.
align the mark on the Magnet on the pressure read
and insert the Magnet vertically in the Locator.
2.
Turn the Magnet until it reaches the extreme position se-
lected.
3.
Then move two positions past stop.
4.
Remove the Magnet vertically to ensure effective re-
locking of the valve rotor in the selected position.
5.
Place the Magnet more than 50 cm from the valve.
6.
Insert the Compass fully into the Locator.
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