Novel Hydrocephalus Valve Addresses Postural Changes

New valve technology integrates gravitational technology with a fixed differential pressure unit into one valve, allowing for a simple, position-dependent hydrocephalus solution.

The Aesculap (Tuttlingen, Germany) M.blue valve is an adjustable gravitational valve with an integrated fixed pressure differential valve that together provide automatic adjustment of the opening pressure during the most active time of the day, when people are standing and moving about; the integration of the fixed pressure differential valve not only addresses the posture changes, and also counteracts the risk of possible over-drainage complications, especially in the upright and active body position.


The differential pressure unit is available in 0,5,10 and 15 cm H₂0, and is effective in all body positions. When lying down, the differential pressure unit acts alone. If the brain pressure rises above the selected opening pressure, a microspiral spring is activated to drain cerebrospinal fluid (CSF). The gravitational unit in the M.blue valve is adjustable from 0-40 cm H20 and is only activated in an upright body position. The combination of both units, gravitational and differential pressure unit, determines the total opening pressure of the M.blue valve.

Design feature include a durable, highly bio-compatible titanium shell, oxidized to display a shade of blue, and a soft touch mechanism that allows for comfortable adjustment. An active-lock mechanism protects it from unintentional reprogramming, not only after a magnetic resonance imaging (MRI) scan, but also from everyday magnets such as smartphones, tablets device, headphones, and hearing devices. For more challenging forms of hydrocephalus, the M.blue plus valve provides an adjustable differential pressure unit (the proGAV 2.0) to provide a customizable solution.

“The patient is our priority and we will continue to invest in research and development to create better solutions,” said Christoph Miethke, CEO and founder of MIETHKE (Potsdam, Germany), the manufacturer of the M.blue hydrocephalus valves for Aesculap. “Our focus on Hydrocephalus valves creates an expertise and openness to future developments that allows us to serve in a way that will improve the lives that we touch.”

“We are very pleased to be able to continue to provide healthcare teams with new and innovative solutions,” said Chuck DiNardo, President of Aesculap. “With our strong partnership with MIETHKE comes an impactful collaborative effort to bring better Hydrocephalus solutions to patients, such as the new M.blue valve.”

Hydrocephalus is a condition in which an excess of CSF accumulates within the ventricles and increases intracranial pressure (ICP) in the brain, resulting in a life-threatening situation. The challenge is to regulate CSF drainage to keep within normal physiological ranges. CSF tends to drain faster when a patient is standing, causing a decrease in ICP, which results in headaches, nausea and other debilitating symptoms. This necessitates the need for higher valve resistance in upright positions; the taller the patient, the higher the necessary resistance.

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