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Updated: Aug 12, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Long-term results after ventriculoatrial shunting in children
O Vernet1, R Campiche, N de Tribolet
1Department of Neurosurgery, University Hospital, Lausanne, Switzerland.
Insights
Ventriculoatrial shunting for infantile hydrocephalus had zero operative mortality but a high revision rate, primarily for atrial catheter adjustment. This suggests ventriculoperitoneal shunting may be preferable for pediatric hydrocephalus treatment.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Medical Device Technology
Background:
- Infantile hydrocephalus presents significant management challenges.
- Ventriculoatrial shunting is a historical treatment option for hydrocephalus.
- Long-term outcomes and complications of shunting procedures require continuous evaluation.
Purpose of the Study:
- To evaluate the long-term outcomes of ventriculoatrial shunting in infantile hydrocephalus.
- To determine the complication rates, including infection and revision rates.
- To compare the suitability of ventriculoatrial shunting versus ventriculoperitoneal shunting for pediatric hydrocephalus.
Main Methods:
- A consecutive series of 120 patients with infantile hydrocephalus underwent ventriculoatrial shunting.
- Follow-up averaged 11 years.
- Data collected on operative mortality, causes of death, infection, slit ventricle syndrome, and shunt revisions.
Main Results:
- Zero operative mortality was observed.
- Seven deaths occurred during follow-up, mostly unrelated to the shunt.
- Infection rate was 4.2%, slit ventricle syndrome 1.8%, with a revision rate of 2.2 per patient.
- 66% of 253 revisions were for elective atrial catheter lengthening.
Conclusions:
- Ventriculoatrial shunting demonstrates low operative mortality but necessitates frequent reoperations.
- The high rate of elective atrial catheter adjustments is a significant disadvantage.
- Ventriculoperitoneal shunting is favored as the primary treatment for pediatric hydrocephalus due to fewer revision requirements.
Abstract:
A consecutive series of 120 patients with infantile hydrocephalus who were subjected to ventriculoatrial shunting was studied. The average length of follow-up was 11 years. Operative mortality was zero. Seven patients died during the follow-up period; in all cases but one of these the cause of death was not a consequence of a shunt-related procedure. The incidences of infection and slit ventricle syndrome were 4.2% and 1.8% respectively. Two hundred and fifty-three shunt revisions were performed, yielding a revision rate of 2.2 per patient. Of these 253 revisions 167 (66%) were elective lengthening of the atrial catheter. The number of reoperations for adjusting the length of the atrial catheter of for revision of the distal end of the shunting system is a major disadvantage of ventriculoatrial shunting which actually speaks in favor of ventriculoperitoneal shunting as the primary procedure for the treatment of pediatric hydrocephalus.
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