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Reconversion to ventriculoperitoneal shunt following ventriculoatrial shunt malfunction in children

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Abstract

Purpose

To analyze the long-term efficacy of the ventriculoatrial shunt (VAS) in pediatric patients with hydrocephalus, focusing on the atrial catheter and suitable revision procedures of the distal catheter following VAS malformation performed at our institution.

Methods

The authors retrospectively analyzed data of 28 pediatric patients under the age of 10 years who were treated with VAS for hydrocephalus and who had a follow-up period of at least 5 years.

Results

A total of 42 atrial tube revision procedures were performed in 28 patients during the study period. The median atrial tube survival time due to atrial tube obstruction was 2.32 years (n = 31, range: 0.4–8.08 years). Atrial tube survival time was shorter in younger children (p < 0.0001) and in children who were shorter in height (p = 0.0001). As a revision procedure following atrial tube malfunction, 22 (78.6%) out of the 28 patients who had an inserted VAS had the VAS reconversion into a VPS at the last follow-up.

Conclusions

VAS can be a useful alternative to VPS, but it requires frequent atrial tube revisions, especially in younger children. Reconversion to VPS after VAS malfunction is a reasonable option and is associated with longer shunt survival time despite its previously observed difficulties.

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Abbreviations

VAS:

Ventriculoatrial shunt

VPS:

Ventriculoperitoneal shunt

References

  1. Rymarczuk GN, Keating RF, Coughlin DJ et al (2019) A comparison of ventriculoperitoneal and ventriculoatrial shunts in a population of 544 consecutive pediatric patients. Neurosurgery 87(1):80–85

    Article  Google Scholar 

  2. Vernet O, Campiche R, de Tribolet N (1995) Long-term results after ventriculo-atrial shunting in children. Childs Nerv Syst 11(3):176–179

    Article  CAS  Google Scholar 

  3. Borgbjerg BM, Gjerris F, Albeck MJ, Hauerberg J, Børgesen SV (1998) A comparison between ventriculo-peritoneal and ventriculo-atrial cerebrospinal fluid shunts in relation to rate of revision and durability. Acta Neurochir 140(5):459–464 discussion 465

    Article  CAS  Google Scholar 

  4. Martin JE, Keating RF, Cogen PH, Midgley FM (2003) Long-term follow-up of direct heart shunts in the management of hydrocephalus. Pediatr Neurosurg 38(2):94–97

    Article  Google Scholar 

  5. Keucher TR, Mealey J Jr (1979) Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 50(2):179–186

    Article  CAS  Google Scholar 

  6. Kariyattil R, Steinbok P, Singhal A, Cochrane DD (2007) Ascites and abdominal pseudocysts following ventriculoperitoneal shunt surgery: variations of the same theme. J Neurosurg 106(5 Suppl):350–353

    PubMed  Google Scholar 

  7. Mobley LW 3rd, Doran SE, Hellbusch LC (2005) Abdominal pseudocyst: predisposing factors and treatment algorithm. Pediatr Neurosurg 41(2):77–83

    Article  Google Scholar 

  8. Erwood A, Rindler RS, Motiwala M et al (2019) Management of sterile abdominal pseudocysts related to ventriculoperitoneal shunts. J Neurosurg Pediatr 2019:1–5

    Google Scholar 

  9. Habibi Z, Golpayegani M, Ashjaei B et al (2020) Suprahepatic space as an alternative site for distal catheter insertion in pseudocyst-associated ventriculoperitoneal shunt malfunction. J Neurosurg Pediatr 2020:1–8

    Google Scholar 

  10. Symss NP, Oi S (2015) Is there an ideal shunt? A panoramic view of 110 years in CSF diversions and shunt systems used for the treatment of hydrocephalus: from historical events to current trends. Childs Nerv Syst 31(2):191–202

    Article  Google Scholar 

  11. Steele J, Stewart R, Komarlu R, Najm H (2018) Large superior vena cava thrombus requiring thrombectomy as a complication of ventriculo-atrial shunt. J Card Surg 33(7):397–398

    Article  Google Scholar 

  12. Tonn P, Gilsbach JM, Kreitschmann-Andermahr I, Franke A, Blindt R (2005) A rare but life-threatening complication of ventriculo-atrial shunt. Acta Neurochir 147(12):1303–1304

    Article  CAS  Google Scholar 

  13. Grover SK, Puri R, Wong TL, Dundon BK, Tayeb H, Steele PM (2010) Ventriculo-atrial shunt induced severe pulmonary arterial hypertension: a time for routine screening? Intern Med J 40(5):386–387

    Article  CAS  Google Scholar 

  14. Amelot A, Bouazza S, George B, Bresson D (2014) Causative role of infection in chronic non-thromboembolic pulmonary hypertension following ventriculo-atrial shunt. Br J Neurosurg 28(4):559–561

    Article  Google Scholar 

  15. Clark DJ, Chakraborty A, Roebuck DJ, Thompson DN (2016) Ultrasound guided placement of the distal catheter in paediatric ventriculoatrial shunts-an appraisal of efficacy and complications. Childs Nerv Syst 32(7):1219–1225

    Article  Google Scholar 

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Acknowledgments

We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Neurosurgery, Miyagi Children’s Hospital, Sendai, Japan

    Shota Yamashita, Tomomi Kimiwada, Toshiaki Hayashi & Reizo Shirane

  2. Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan

    Teiji Tomonaga

Authors
  1. Shota Yamashita
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  2. Tomomi Kimiwada
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  3. Toshiaki Hayashi
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  4. Reizo Shirane
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  5. Teiji Tomonaga
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Correspondence to Tomomi Kimiwada.

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The authors report no conflicts of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Yamashita, S., Kimiwada, T., Hayashi, T. et al. Reconversion to ventriculoperitoneal shunt following ventriculoatrial shunt malfunction in children. Childs Nerv Syst 37, 2207–2213 (2021). https://doi.org/10.1007/s00381-021-05045-7

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  • DOI: https://doi.org/10.1007/s00381-021-05045-7

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