Development and in-vitro characterization of a novel fetal vesicoamniotic shunt – The Vortex shunt Journal Article


Authors: Sheth, K. R.; Danzer, E.; Johnson, E.; Wall, J. K.; Blumenfeld, Y. J.
Article Title: Development and in-vitro characterization of a novel fetal vesicoamniotic shunt – The Vortex shunt
Abstract: Objectives: To develop and test a novel vesicoamniotic shunt (VAS) to treat fetal lower urinary tract obstruction (LUTO), decrease dislodgement and optimize shunt deployment in-vitro. Methods: Vesicoamniotic shunt design objectives included: (1) robust and atraumatic fixation elements, (2) kink resistant conduit to adjust to fetal movement and growth, (3) one-way pressure valve to facilitate bladder cycling, and (4) echogenic deployment visualization aids. The force to dislodge the novel Vortex shunt was compared with existing commercially available shunts in a bench-top porcine bladder model. Sonographic echogenicity was evaluated with ultrasound-guided deployment, and the shunt valve pressure measured. Results: A prototype novel Vortex shunt was developed using braided nitinol “umbrella-type” ends with a kink-resistant stem incorporating an internal one-way valve. The peak force required to dislodge the Vortex shunt was significantly higher than commercially available shunts (p < 0.01). Shunt deployment in the bench-top model was easily confirmed with ultrasound guidance and the brisk decompression of the inflated porcine bladder thereafter. In-vitro valve gauge pressure testing mirrored bladder pressures in human LUTO cases. Conclusion: In-vitro testing shows that the Vortex shunt may improve deployment, sonographic visualization, kink resistance, and dynamic size adjustment. Validation in preclinical animal models are warranted and currently underway. © 2022 John Wiley & Sons Ltd.
Journal Title: Prenatal Diagnosis
Volume: 42
Issue: 2
ISSN: 0197-3851
Publisher: John Wiley & Sons  
Date Published: 2022-02-01
Start Page: 164
End Page: 171
Language: English
DOI: 10.1002/pd.6096
PUBMED: 35048376
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 March 2022 -- Source: Scopus
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  1. Enrico Danzer
    16 Danzer