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Adjustable gravitational valve for the treatment of hydrocephalus® – the next generation

MIETHKE® gravitational valve – the next shunt generation

Functionality of valve and position of the body

The® is a hydrocephalus valve operating in a position-dependent manner. It consists of an adjustable gravitational unit and a fixed differential pressure unit.® functionality of hydrocephalus valve

The combination of these two units ensures automatic adjustment of the opening pressure depending on the patient's body position and thus counteracts the risk of possible overdrainage complications, especially in the upright and active body position. [5], [6], [7], [8] Particularly challenging and difficult forms of hydrocephalus require a much greater flexibility in treatment. This is what the plus® stands for: a combination of an adjustable gravitational unit and an adjustable differential pressure unit (proGAV® 2.0). Both® variants are made of robust and biocompatible titanium and are the result of precise precision engineering.

Gravitational valves positioning of the body
MIETHKE® gravitational valve – the next shunt generation

XABO® antibiotic impregnated catheters perfectly fit to our innovative MIETHKE® valve. It offers long-lasting antimicrobial effects for at least 38 days after implantation, easy handling as it withstands temperatures up to 30°C without losing its effectiveness [21] and convenient storage for up to 36 months.

Two mobile devices with the MIETHKE app

Valve adjustment

User-friendly adjustment and verification plus® instruments allow users to measure, verify, and adjust the pressure level on®’s adjustable gravitational unit (0-40 cmH2O) as well as the pressure level on the adjustable differential pressure unit (proGAV® 2.0) of plus®. The instruments offer simple steps for the physician and make the adjustment process comfortable for patients. [22]® valve compass and adjustment ring
Illustration how to locate plus®
Illustration how to verify plus®
Illustration how to adjust plus®

Related documents

  • Standard pressure levels for® and plus®


    pdf, 111.0 KB

  • Challenges for hydrocephalus shunt development

    Info graph

    pdf, 45.4 KB

  • MIETHKE Gravitational valves – designed to give you confidence

    Info graph

    pdf, 36.8 KB

  •® – shunt system for the treatment of hydrocephalus

    Patient manual


  •® – the balanced way of life. Inspired by you.



  • XABO® Antibiotic impregnated catheters – Xtra protection against infection



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[4] NPH-Leitlinien der DGN 2018

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[6] 2014, Tschan C. A., Antes S., Huthmann A., Vulcu S., Oertel J. and Wagner W.: "Overcoming CSF overdrainage with the adjustable gravitational valve proSA", Acta Neurochir (Wien) 156(4): 767-776,

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[8] 2016, May, Gebert A. F., Schulz M., Schwarz K. and Thomale U. W.: "Longterm survival rates of gravityassisted, adjustable differential pressure valves in infants with hydrocephalus", J Neurosurg Pediatr 17(5): 544-551

[9] 2016, May 15, Miyake H.: "Shunt Devices for the Treatment of Adult Hydrocephalus: Recent Progress and Characteristics", Neurol Med Chir (Tokyo)

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[14] Fernández-Méndez R, Richards HK, Seeley HM, et al. Current epidemiology of cerebrospinal fluid shunt surgery in the UK and Ireland (2004-2013). J Neurol Neurosurg Psychiatry 2019;90(7):747-54.

[15] Blount JP, Campbell JA, Haines SJ. Complications in Ventricular Cerebrospinal Fluid Shunting. Neurosurgery Clinics of North America 1993;4(4):633-56.

[16] Darouiche RO. Treatment of infections associated with surgical implants. N Engl J Med 2004;350(14):1422-29.

[17] Walters BC, Hoffman HJ, Hendrick EB, et al. Cerebrospinal fluid shunt infection. Influences on initial management and subsequent outcome. J Neurosurg 1984;60(5):1014-21.

[18] Sciubba DM, Stuart RM, McGirt MJ, et al. Effect of antibiotic-impregnated shunt catheters.

[19] Mallucci CL, Jenkinson MD, Conroy EJ, et al. Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multicentre, single-blinded, randomised trial and economic evaluation. The Lancet 2019;394(10208):1530-39.

[20] MIETHKE report. Data on file.

[21] MIETHKE report. Data on file.

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