gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Pulmonary hypertension caused by ventriculoatrial shunt : a serious complication of a simple neurosurgical procedure

Pulmonaler Hochdruck: eine unterschätzte Komplikation des ventrikuloatrialen Shunts

Meeting Abstract

  • corresponding author U. Kehler - Department of Neurosurgery, University Hospital Eppendorf, Hamburg
  • S. Kluge - Department of Internal Medicine 1, University Hospital Eppendorf, Hamburg
  • A. Meyer - Department of Internal Medicine 1, University Hospital Eppendorf, Hamburg
  • B. Koziej - Department of Internal Medicine 1, University Hospital Eppendorf, Hamburg
  • J. Regelsberger - Department of Neurosurgery, University Hospital Eppendorf, Hamburg
  • M. Westphal - Department of Neurosurgery, University Hospital Eppendorf, Hamburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP142

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0410.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Kehler et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Pulmonary hypertension may be caused by ventriculoatrial shunts. The patho-physiology is not understood completely. The symptoms often develop slowly and remain undetected over years. This evaluation should detect the incidence, severity, and course of shunt-associated pulmonary hypertension.

Methods

Retrospectively 30 patients who had a ventriculoatrial shunt were reexamined for clinical history and for pulmonary hypertension.

Results

Four of 30 patients showed a pulmonary hypertension. All patients were females. The mean age of the patients at diagnosis of pulmonary hypertension was 45,25 years (range: 37-58). The shunt implantation was 9 to 24 years ago (mean: 16,5). In 1 patient comorbidity (pulmonary embolism and tuberculosis) was present before VA-shunt implantation. The mean pulmonary artery pressure was 55.7±5 mmHg, the heart index was 1.9±0.3 l/min/m2, the walking distance in the 6min walking test was 310.8±85.7 m. All patients were initially in NYHA grade 3-4. One patient needed heart-lung transplantation; the other 3 patients are severely handicapped and need an extensive drug combination therapy. The clinical symptoms progressed although the shunts were changed to the peritoneum or gall bladder.

Conclusions

Ventriculoatrial shunts may cause severe pulmonary hypertension. The knowledge of this complication and the severity of this course indicats an even greater restriction in the indication for ventriculoatrial shunts.