Shunt audit: a computerized method for testing the performance characteristics of CSF shunts in vitro.

Abstract

Studies of long-term shunt performance in vivo demonstrate that some 81% fail within 12 years. Such failure is multifactorial in origin: the patient, the surgical technique and the shunt may all prove fallible. Recent studies have shown that there is considerable variability of the performance characteristics of individual shunts when tested for short time periods in relatively simple rigs, and that they do not always behave according to the manufacturers' specifications. We have developed a computerized shunt rig for the long-term evaluation of a valve's performance in vitro using both pressure-flow studies (where flow through the shunt is evaluated for controlled differential pressure across the shunt) and flow-pressure studies (where the differential pressure across the shunt is evaluated for controlled flow rates through the shunt). This rig consists of a pressure transducer, electronic balance, computer-controlled infusion pump and blood pressure systems calibrator that stimulates different wave form patterns. An IBM PC controls all the devices and evaluates the performances characteristics according to various test protocols. Our initial observations with this rig confirm that progressive changes in shunt function occur over long periods of time (weeks).