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Ventriculopleural shunt outcomes for pediatric hydrocephalus: a single-institution experience

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Abstract

Purpose

The aim of this study is to analyze rates of ventriculopleural (VPL) shunt failure and complications among patients with pediatric hydrocephalus, and to analyze which factors may predict early (< 1 year) or late (> 1 year) VPL shunt failure in this sample.

Methods

A retrospective chart review was conducted of all consecutive VPL shunt placements from 2000 to 2019 at our institution. Data was collected on patient characteristics, shunt history, and shunt type. Primary endpoints include rates of VPL shunt survival and rates of symptomatic pleural effusion. The Kaplan–Meier method was used to calculate shunt survival, and Fisher’s exact test and t-test were used to compare differences between categorical variables and means, respectively (p < 0.05).

Results

Thirty-one patients with pediatric hydrocephalus underwent VPL shunt placement (mean age 14.2 years). Of the 27 patients with long-term follow-up (mean 46 months), VPL shunt revision was required in 19, seven of which were due to pleural effusion. Overall shunt survival rates at 1, 3, 5, and 7 years were 76%, 62%, 55%, and 46%, respectively. Mean duration of shunt survival was 26.74 months. Overall pleural effusion rate was 26%. No patient-specific factors, including shunt valve type, were significantly associated with shunt survival, risk of early revision, or risk of pleural effusion.

Conclusions

Our results are comparable to those reported in the literature and represent one of the largest case series on the topic. VPL shunts are a viable second-line option when ventriculoperitoneal (VP) shunt placement is not possible or desirable, though there are high rates of shunt revision and pleural effusion.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Daniel E. Oyon, Luis G. Fernandez III, William Gibson & Tadanori Tomita

  2. Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Daniel E. Oyon, Mandana Behbahani, Shelly Sharma, Dana E. Coons, Tatiana Pundy, Luis G. Fernandez III, William Gibson & Tadanori Tomita

Authors
  1. Daniel E. Oyon
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  2. Mandana Behbahani
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  3. Shelly Sharma
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  4. Dana E. Coons
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  5. Tatiana Pundy
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  6. Luis G. Fernandez III
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  7. William Gibson
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  8. Tadanori Tomita
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Contributions

Daniel Oyon, Mandana Behbahani, and Tadanori Tomita devised the study design. Daniel Oyon and Shelly Sharma wrote the main manuscript text. Daniel Oyon, Shelly Sharma, Luis Fernandez, and William Gibson prepared the tables and figures. Daniel Oyon and Shelly Sharma conducted the statistical analysis. Dana Coons, Tatiana Pundy, Luis Fernandez, and William Gibson collected the individual patient data. All authors reviewed the manuscript.

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Correspondence to Daniel E. Oyon.

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Oyon, D.E., Behbahani, M., Sharma, S. et al. Ventriculopleural shunt outcomes for pediatric hydrocephalus: a single-institution experience. Childs Nerv Syst 39, 2105–2113 (2023). https://doi.org/10.1007/s00381-023-05928-x

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  • DOI: https://doi.org/10.1007/s00381-023-05928-x

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