Patient information – Denver™ shunt

Understand our Denver™ shunt and how it works

Our Denver shunt helps manage ascites using a therapy called peritoneovenous shunting (PVS).

This therapy can help:

  • Retain nutrients.
  • Improve movement and breathing.
  • Improve appetite by reducing the feeling of fullness.
  • Increase blood flow through the kidneys.
  • Increase elimination of excess fluid.
  • Provide fast relief from ascites symptoms for most patients.

Denver shunt FAQ

How do I pump my shunt?

After locating the pump chamber on your lower rib cage, which your physician may have marked:

  1. Lie on your back.
  2. Firmly press the center of the chamber down as far as you can.
  3. Release the chamber.
  4. Wait a second for the pump chamber to refill.
  5. Repeat.

How often should I pump my shunt?

Unless otherwise instructed by your physician, pump it while lying down 20 consecutive times in the morning right after waking up and 20 consecutive times at night before going to sleep.

How much fluid goes through my shunt each time I pump it?

Each pump moves 1 mL of fluid from your abdomen, through the shunt, into your vein. Thus, each session moves 20 mL of fluid, which is less than an ounce of fluid, or about 4 tsp. Remember, pumping primarily helps prevent clogging. Fluid moves on its own through the shunt.

I knew how much fluid paracentesis drained. Can I tell how much fluid my shunt drains?

Fluid will spontaneously flow through your shunt throughout the day, whenever it builds up enough to push through the shunt and into your vein. Estimating how much fluid is flowing or its flow rate is difficult, since each patient is different.

Whom should I call if I experience issues with my shunt? Should I go to the ER?

Call the physician who placed your shunt. The issues are likely due to clog, which does not require a visit to the ER.

How long will I leave my shunt in place?

As long as it is controlling your ascites. Some patients leave it in a year or longer.

What should I do if I cannot pump my shunt?

Your shunt may be clogged. Call the physician who placed the shunt, as he or she can repair or replace it relatively easily.

What if the fluid starts to build up again?

If your shunt controlled your fluid, but the fluid is now starting to build up again, the shunt may be clogged. Call the physician who placed the shunt, as he or she can repair or replace it relatively easily.

How to pump your shunt

1

Locate your pump chamber. It should be on your lower rib cage; your physician may have marked its location. Lie on your back, firmly press the center of the chamber down as far as you can and then release it. Wait a second for the pump chamber to expand and then repeat this process.

2

Pump as instructed by your physician.

  • Your physician may have instructed you to pump 20 times twice a day; once upon waking and once at bedtime (to clear out the valves and reduce risk of clogging). Pump while lying down.
  • Pumping may be uncomfortable at first if the pump chamber is close to the incision site. Once the incision site heals, it should not be painful.
  • It is best to pause for a second between each pump, so the pump chamber re-expands.
  • Only if your physician indicated you have a single valve shunt, lie on your back. Compress the pump chamber with one hand. Before releasing it, press or pinch the tubing that you feel under your skin, about an inch above the pump chamber. As you continue to press or pinch the tubing, release the pump chamber. Then release the tubing. Continue to pump in this alternating fashion 20 times, two times a day.

3

Watch for signs that the shunt is not functioning, such as:

  • Your abdomen fills with fluid again.
  • The pump chamber is solid; it cannot be compressed.
  • The pump chamber, once compressed, does not return to normal (it does not re-expand).

4

If your ascites returns or the shunt seems clogged, immediately contact the physician who implanted your shunt. He or she can repair or replace the shunt in most cases.

5

If you need any medical procedures, especially laparoscopic surgery, tell your physician about your Denver shunt. He or she must prevent air from entering the shunt.