Modern Era Shunts Valves

The modern era of shunts owes its origin to the development of one-way valves by Spitz and Holter as well as by Pudenz. Polyvinyl chloride was initially used, but it was soon evident that silastic was better tolerated by the body.

The most popular shunting operation of this era was the ventriculoatrial shunt, in which the distal end of the catheter was introduced into the jugular vein and then to the right atrium. Numerous other sites for drainage have been reported, including the subdural space, mastoid air cells, thoracic lymphatic duct, fallopian tube, gall bladder, salivary ducts, stomach, and small intestine. Most of these sites are rarely, if ever, used today.

Ventriculoatrial shunting remained the most popular shunting procedure until ventriculoperitoneal procedures began to gain popularity at the end of the 1960s. The ventriculoperitoneal shunt was attractive for its simplicity, the absence of a permanent foreign body in the vascular system, and the reduced need for revision with inevitable growth of the patient.

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