Ball and spring or slit and core valve for hydrocephalus shunting?

Ventriculoperitoneal or ventriculoatrial shunting is the main method used in the management of hydrocephalic children. It is, however, associated with frequent complications. In order to reduce the risk of complications several types of shunts have been developed. In vitro studies have been performed to compare different types of shunts (1), but clinical studies concerning the efficiency of different shunt constructions are scanty (2). In the present study the Hakim-Cordis valve and the Pudenz-Heyer valve were compared in a series of 148 patients who had undergone 573 shunt operations for hydrocephalus. No significant differences were observed in the efficiency of these two shunts, though there was an increased rate of catheter rupture for the Pudenz-Heyer valve and an increased tendency for development of slit ventricles for the Hakim-Cordis valve. The patency rate for the Pudenz-Heyer valve proved to be statistically significantly higher (p less than 0.001) than that for the Hakim-Cordis valve, while there was a slight difference in the tolerance for high CSF protein levels favoring the Hakim-Cordis valve.