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Pulmonary valvular dysfunction in children with ventriculovenous shunts for hydrocephalus: a previously unreported
Insights
A rare heart issue in children with hydrocephalus shunts was found. Catheter movement can disrupt the pulmonary valve, requiring intervention or monitoring.
Area of Science:
- Pediatric Cardiology
- Neurosurgery
- Medical Device Complications
Background:
- Ventriculovenous shunts are used to treat hydrocephalus in children.
- Cardiovascular complications associated with these shunts are uncommon but can be serious.
- Pulmonary valve involvement due to shunt malfunction has not been widely reported.
Purpose of the Study:
- To describe a previously unreported cardiovascular complication of ventriculovenous shunts.
- To highlight the role of catheter migration in pulmonary valve dysfunction.
- To review existing literature on cardiovascular issues related to ventriculovenous shunts.
Main Methods:
- Case report of two pediatric patients with hydrocephalus and ventriculovenous shunts.
- Clinical examination, echocardiography, and imaging to assess cardiac function and catheter position.
- Review of relevant medical literature.
Main Results:
- Two boys presented with cardiovascular complications involving the pulmonary valve apparatus.
- Catheter migration caused the proximal end to interfere with pulmonary valve function.
- Surgical removal of the migrated catheter resolved cardiac findings in one patient; the other was managed conservatively due to catheter position and mild hemodynamic effects.
Conclusions:
- Catheter migration is a potential cause of pulmonary valve complications in ventriculovenous shunts for hydrocephalus.
- Prompt diagnosis and appropriate management (surgical or conservative) are crucial.
- Increased awareness of this complication is necessary for pediatric neurosurgeons and cardiologists.
Abstract:
A hitherto unreported cardiovascular complication of ventriculovenous shunts for hydrocephalus, involving the pulmonary valve apparatus, is described in two boys. This complication was the result of catheter migration with its proximal end interfering with pulmonary valve function. In one case the embolized catheter was removed by thoracotomy resulting in disappearance of the cardiac findings, whereas in the other case the catheter was in situ because of its peripheral position in the lung and the relatively insignificant hemodynamic disturbances of the pulmonary valve. The pertinent literature on the cardiovascular complications of ventriculovenous shunts for hydrocephalus is also reviewed.