MIETHKE Shunt Systems

Gravitational Shunt Valves

Be Active with Gravitational Shunt Valves 

MIETHKE gravitational valves actively vary their opening pressure to compensate for changing body positions, whether sleeping, sitting, standing, walking or playing. They provide physiological drainage, helping to reduce discomfort so patients can participate in the activities they enjoy most, longer.  

It is all about Physics 

Gravity affects the cerebrospinal fluid (CSF) in the shunt catheter, causing the shunt to drain more CSF when the patient is standing and to drain less CSF when the patient is lying flat. Draining too much or too little CSF can cause discomfort, such as headaches, nausea, vomiting, and in extreme cases of over-drainage, subdural hematomas. To compensate, the opening pressure of the shunt valve should be higher when the patient is standing and lower when the patient is lying flat. 

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M.blue™ Valve

ONE valve for the special requirements of a life with hydrocephalus: mobility, growth and changes in the course of the condition. 

  • Unique, uncompromising pressure adaptation to optimize individual patient needs
  • MR Conditional up to 3 Tesla – no X-ray verification after MRI necessary and no additional radiation exposure for the patient 
  • Protects from unintentional adjustment by everyday magnets such as smartphones, toys, hearing devices, induction cookers and airport safety barriers 

proGAV® 2.0  Valve 

Comfortable, reliable and proven technology. 1,2,3

  • “Active Lock” mechanism provides security against inadvertent readjustment caused by magnetic field emissions 4,5 (i.e. MRI*, household appliances, hearing devices, headphones, toys) 
  • Highly biocompatible titanium housing allows for low profile design for improved aesthetics and easy implantation 
  • 0–20 cm H20 pressure settings allow for a custom approach and a wide range of treatment options for individual patient needs 

*3 Tesla or less 

miniNAV®  Valve 

The world’s smallest differential pressure valve with reliable drainage control for the treatment of hydrocephalus. 

  • Ultra-small, slim design makes it an ideal choice for pediatric hydrocephalus 
  • Titanium housing allows the miniNAV Valve to be made extremely small, but still have large flow paths for cerebrospinal fluid 
  • Available in four pressure levels to help manage the complex need of different patients 


The SHUNTASSISTANT 2.0 Valve proves its strength in combination with other valves. 

  • Gravitational technology gradually adapts the opening pressure automatically and counteracts possible overdrainage 
  • Can be combined with a differential pressure valve (fixed or adjustable) as an initial solution or as a secondary add on device for patients with existing complications 

GAV® 2.0  Valve 

The new generation of gravity assisted valve system 

  • Combination of a differential pressure and a gravitational unit to provide automatic opening pressure adjustment to a patient's body position and counteracts complications due to overdrainage 
  • Slender cylindrical design for improved aesthetic and easy implantation, suitable for adults as well as pediatric patients

1 Thomale UW, Gerbert AF, Haberl H, Schulz M. Shunt survival rates by using the adjustable differential pressure valve combined with a gravitational unit (proGAV) in pediatric neurosurgery. Childs Nerv Syst. 2013 Mar; 29(3):425-31. 

2  Lemcke J, Meier U, Muller C, Fritsch MJ, Kehler U, Langer N, Kiefer M, Eymann R, Schuhmann MU, Speil A, Weber F, Remenez V, Rohde V, Ludwig HC, Stengel D. Safety and efficacy of gravitational shunt valves in patients with idiopathic normal pressure hydrocephalus: a pragmatic, randomised, open label, multicentre trial (SVASONA). J Neurol Neurosurg Psychiatry. 2013 Aug; 84(8):850-57.

3  Allin DM, Czosnyka ZH, Czosnyka M, Richards HK, Prickard JD. In vitro hydrodynamic properties of the Miethke proGAV hydrocephalus shunt. Cerebrospinal Fluid Res. 2006 Jun; 3:9.

4  Pierson MJ, Wehrmann D, Albers JA, El Tecle NE, Costa D, Elbabaa SK. Programmable shunt valve interactions with osseointegrated hearing devices. J Neurosurg Pediatr. 2017 Apr; 19:384-390.

5  Spader HS, Ratanaprasatporn L, Morrison JF, Grossberg JA, Cosgrove GR.  Programmable shunts and headphones:  Are they safe together? J Neurosurg Pediatr, 2015 Oct; 16:402-405