Cor pulmonale: a lethal complication of ventriculoatrial CSF diversion

We report the case of a child with cor pulmonale due to chronic thromboembolism from a ventriculoatrial shunt. The patient's pulmonary hypertension and heart failure did not resolve after removal of the atrial catheter and conversion to a ventriculoperitoneal system, and death ensued 2 months later. The reasons for the historical ascendancy of ventriculoperitoneal over ventriculoatrial shunts must be recalled when circumstances make the peritoneal cavity an unsuitable receptacle for CSF diversion. Patients with ventriculoatrial shunts must be monitored for cardiopulmonary complications.