Mural thrombi of the right atrium and acute bacterial endocarditis complicating a LeVeen shunt

A cirrhotic woman with a LeVeen shunt developed right atrial thrombi, acute bacterial endocarditis, and a major pulmonary embolus. The right atrial mural thrombi and resultant pulmonary emboli arose as a result of the placement of the venous end of the LeVeen shunt within the right atrium. This untoward event must be added to the growing list of complications associated with the placement of such catheters.