title: A prospective randomized trial demonstrating valved implantable ports have fewer complications and lower overall cost than nonvalved implantable ports.
abstract: BACKGROUND
  The purpose of the current study was to evaluate whether a totally implanted valved subcutaneous port system would have fewer complications as compared to a standard nonvalved port.
  
  
  METHODS
  Study subjects requiring port placement were randomized to receive a valved port (PASV; Boston Scientific, Natick, MA) or a nonvalved port (BardPort; Bard Accesss Systems, Salt Lake City, UT). Each port was placed with standard operative technique. Difficulty with blood return, excess time spent accessing the port, and required interventions were reported over the initial 180 days of port usage.
  
  
  RESULTS
  Seventy-three patients were randomized to receive either a valved port (n = 37) or a nonvalved port (n = 36). No major complications were identified from port placement, and there were no differences in rates of infection between the 2 ports. A reported inability to withdraw blood was noted in the valved port group on 21 of 364 (5.8%) port accessions and in the nonvalved port group on 37 of 341 (11%) accessions (P = 0.02). Significantly more total time was spent ensuring adequate blood draw from nonvalved ports as opposed to valved ports (750 minutes vs. 1545 minutes, respectively) (P <0.03).
  
  
  CONCLUSIONS
  This study revealed that the PASV valved port is associated with significantly fewer instances of poor blood return and less nursing access time, indicating that a port with a PASV valve may be superior to a nonvalved device.
authors.affiliation: Department of Surgery, Baylor University Medical Center, 3409 Worth Street, Ste. 420, Dallas, TX 75246, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Carlo
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Lamont
authors.forename: Todd M
authors.initials: TM
authors.lastname: McCarty
authors.forename: Sheryl
authors.initials: S
authors.lastname: Livingston
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Kuhn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000379:methods; D003362:Cost-Benefit Analysis; D004867:Equipment Design; D004868:Equipment Failure; D004869:Equipment Safety; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000517:prevention & control