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Peruvian Journal of Neurosurgery

Malfunction of the valvular shunting system in children. Experience in the Neurosurgery Department of the Baca Ortiz Pediatric Hospital, Quito-Ecuador, 2016-2019

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Introduction: The prevalence of valve dysfunction (VD) in pediatric centers is high. A descriptive observational study was carried out, the objective of which was to find factors: epidemiological characteristics of hydrocephalus and other derivatives of the ventricle-peritoneal shunt system (VPSS) associated with VD.

Methods: All the diagnoses of VD for 3 years in the Neurosurgery Service of the Baca Ortiz Pediatric Hospital (BOPH) were collected, clinical-epidemiological variables associated with hydrocephalus and shunting were selected. VD was defined as the revision of the referral in patients using VPSS for malfunction. Multi-categorical variables and the prevalence of qualitative variables were analyzed using statistical analysis.

Results: A total of 376 children were initially subjected to VPSS placement between August 2016 and August 2019. 71 patients with VD were treated, of whom 60 were included in the study; of these 48 were treated at BOPH. Infectious dysfunction was found to be more frequent in children < 1-year, mechanical dysfunction in children > 5 years (64% and 38% respectively p <0.002). Also, the permanence of the VPSS <1 year was more frequent in infectious dysfunctions and the permanence of 1 to 5 years was more related to mechanical dysfunction (72 and 46% respectively p 0.03). The distal catheter dysfunction was more important in mechanical and mixed etiology (65.41 respectively p <0.001) and that of the ventricular catheter in infectious etiology (81% p <0.001). No independent association of VD was found with the etiology of hydrocephalus, the ventricular catheter site or with the Lansky scale.

Conclusions: Valvular dysfunction in pediatric hydrocephalic patients is an important complication that warrants further investigation.

        Keywords: Hydrocephalus, Catheters, Neurosurgical Procedures, Hospitals, Pediatric. (Source: MeSH NLM)