gms | German Medical Science

Objective: Ventriculopleural shunts are used as an alternative to ventriculoatrial or ventriculoperitoneal shunts, especially when the peritoneal cavity is not available and the atrium difficult to reach. Typical complications of ventriculopleural shunts are pleural effusion and pneumothorax. In the years 1996 to 2005, 19 patients with hydrocephalus have been treated by ventriculopleural shunt in our department. These cases have recently been reviewed in order to evaluate the efficacy and complication rate of ventriculopleural shunting.

Methods: We reviewed the history and the follow-up of 19 patients, who underwent ventriculopleural shunting procedures from 1996 to 2005 at our service. The indication for this procedure and its complications are analyzed and compared to former studies (Hoffmann et al. 1983, Megison et Benzel 1988, Piatt 1994, Martinez-Lage et al. 2000).

Results: The most common indication for ventriculopleural shunting was peritoneal infection due to a previous ventriculoperitoneal shunt. Pleural effusion occurred twice, pneumothorax was not notified. Unspecific complications were valve disfunction (2), and dislocation of the distal catheter (1), which needed revision surgery. Infection of the distal catheter occurred 4/19, all of them patients, who underwent ventriculopleural shunting as a salvage procedure after several infections of previous ventriculoperitoneal shunts. The complication rate is comparable to former studies.

Conclusions: We state that ventriculopleural shunts are a safe alternative to ventriculoperitoneal shunting. Specific complications are rare compared to unspecific problems.