Indications for thoracic placement of the ventriculoperitoneal pumping chamber

The bulkiest portion of the shunts commonly used to divert the cerebrospinal fluid into the atrial or pleureal cavities is traditionally implanted under the skin behind, and above the ear. The scalp in this location is often thin and tightly attached to the underlying bone. Placement of these bulky devices beneath the skin may cause erosion of the scalp and exposure of the shunt. When erosion and infection occur, the shunt has to be removed. Reinsertion of the shunt is possible by placing the bulkiest portion, the pumping chamber, below the clavicle over the second rib.