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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Vegetation of Ventriculoatrial Shunt Managed via Multidisciplinary Surgical Approach

Pouya Entezami1, Neil S Devejian2, Sebastian Rubino1

  • 1Department of Neurosurgery, Albany Medical College, Albany, New York, USA.

World Neurosurgery
|August 14, 2020
PubMed

Insights

Ventriculoatrial shunts, though less common, can lead to serious atrial thrombus complications. Early recognition and a multidisciplinary team approach are crucial for successful patient outcomes.

Area of Science:

  • Neurosurgery
  • Cardiothoracic Surgery
  • Pediatric Hydrocephalus Management

Background:

  • Ventriculoatrial shunts were historically used for cerebrospinal fluid diversion.
  • Their use has declined due to the success of ventriculoperitoneal shunts.
  • Ventriculoatrial shunts remain a viable option when other methods are not feasible.

Observation:

  • A case of a 9-year-old girl with a ventriculoatrial shunt experiencing multiple revisions.
  • The patient developed wound dehiscence, leading to bloodstream infection and atrial thrombus formation.
  • The thrombus, presumed granuloma, was located at the distal catheter tip in the right atrium.

Findings:

  • Atrial thrombus formation is a significant complication associated with ventriculoatrial shunts.
  • Successful surgical removal of the atrial thrombus was achieved through a collaborative cardiothoracic approach.
  • Previous literature indicates a high mortality rate associated with these shunt-related lesions.

Implications:

  • Recognizing the risk of atrial thrombus is vital for managing patients with ventriculoatrial shunts.
  • A collaborative, team-based approach involving neurosurgery and cardiothoracic surgery improves patient outcomes.
  • Despite limitations, ventriculoatrial shunts remain relevant in specific neurosurgical contexts.
Abstract

Keywords:
Cardiac surgeryCerebrospinal fluid disordersInfectionVentriculoatrial shunts

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