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Coronary sinus thrombosis and myocardial infarction secondary to ventriculoatrial shunt insertion
1Nuffield Department of Pathology, University of Oxford, England.
Journal of Pediatric Surgery
|December 1, 1990
Insights
Coronary sinus thrombosis occurred in a girl with spina bifida after shunt revision, leading to myocardial infarction and sudden cardiac arrest. This case highlights a rare but fatal complication of ventriculoatrial shunts.
Area of Science:
- Cardiology
- Pediatric Surgery
- Neurology
Background:
- Ventriculoatrial shunts are used to treat hydrocephalus, a common complication of spina bifida.
- Shunt revisions are sometimes necessary due to malfunction or blockage.
- Coronary sinus thrombosis is a rare but serious complication that can occur post-surgery.
Observation:
- A necropsy was performed on a young female patient with spina bifida.
- The patient had undergone a ventriculoatrial shunt revision procedure.
- Evidence of coronary sinus thrombosis was identified during the examination.
Findings:
- The coronary sinus thrombosis was directly linked to secondary myocardial infarction.
- The infarction was located near the heart's conducting system in the interventricular septum.
- This cardiac event is proposed as the cause of the patient's sudden death.
Implications:
- This case underscores the potential for rare thrombotic complications following ventriculoatrial shunt procedures.
- Awareness of this complication is crucial for pediatric surgeons and cardiologists managing these patients.
- Further research may be warranted to elucidate the mechanisms and preventative strategies for shunt-related thrombosis.
Abstract:
Coronary sinus thrombosis was found at necropsy in a girl with spina bifida who underwent ventriculoatrial shunt revision. There was secondary myocardial infarction, close to the conducting system within the interventricular septum. We suggest that this led to cardiac arrest and sudden death.