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Published on: August 16, 2021
[Intracardiac migration of a ventriculoperitoneal shunt. A systematic literature review and case report]
A V Stanishevskiy1, M A Legzdain1, N R Saburov1
1Kirov Military Medical Academy, Saint Petersburg, Russia.
Insights
Distal catheter migration into the heart is a rare but serious complication of cerebrospinal fluid (CSF) shunting. Early identification and consideration of risk factors are crucial for managing this ventriculoperitoneal shunt issue.
Area of Science:
- Neurosurgery
- Cardiology
- Medical Complications
Background:
- Cerebrospinal fluid (CSF) shunting is a common neurosurgical procedure.
- Distal catheter migration is a rare but significant complication of CSF shunts.
- This study focuses on peritoneal catheter migration into the heart chambers.
Abstract:
CSF shunting procedures are common in neurosurgery. A rare complication of these procedures is migration of distal catheter. We present a case of peritoneal catheter migration into the right heart chambers. A systematic review of appropriate literature data was carried out.
Material And Methods:
We present a patient with communicating hydrocephalus after previous penetrating traumatic brain injury. Migration of peritoneal catheter into the right heart chambers occurred in 5 days after ventriculoperitoneal shunting. We performed a systematic review of literature data and analyzed all similar cases of intracardiac migration of ventriculoperitoneal catheter, risk factors of migration, possible complications and surgical treatments.
Results:
There were 38 articles describing 40 cases of distal catheter migration into the right heart chambers meeting the inclusion criteria. In 65% of patients, catheter migration was diagnosed after ≥2 months. Migration was asymptomatic in 21% of cases. Additionally, less than 50% of patients had no complications. Surgical treatment required complex techniques such as endovascular removal or thoracotomy in nearly 50% of cases.
Conclusion:
Migration of ventriculoperitoneal catheter into the right heart chambers is a rare and dangerous complication of CSF shunting procedures. Risk factors of this complication should be considered when scheduling surgical treatment and follow-up examinations.
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