gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Intracardiac migration of the distal ventriculoatrial shunt catheter – Report of two cases and review of the literature

Meeting Abstract

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  • M. Renovanz - Klinik für Neurochirurgie, Klinikum Stuttgart, Katharinenhospital
  • N. Hopf - Klinik für Neurochirurgie, Klinikum Stuttgart, Katharinenhospital

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 110

doi: 10.3205/12dgnc496, urn:nbn:de:0183-12dgnc4969

Published: June 4, 2012

© 2012 Renovanz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: In the management of hydrocephalus has been shown that ventriculoatrial (VA-) shunts have a higher rate of severe complications than ventriculoperitoneal (VP-) shunts. Two cases of intracardiac migration of a distal catheter, in one case with successful retrieval are presented. In addition a review of the literature is provided.

Methods: A 15-year-old female dysraphic patient suffered from headache and nausea. In addition, she presented an episode of tachycardia. A chest radiograph showed that the atrial catheter was disconnected and had migrated into heart and pulmonary artery. An endovascular removal of the migrated intracardiac shunt catheter could be achieved. The VA-shunt was converted into a VP-system again. A 69-year-olf female patient presented with unclear lower back pain, but no hydrocephalic symptoms. A routine MRI showed no recurrence of hydrocephalus, chest radiograph showed that the atrial catheter was disconnected and had migrated into the right atrium. No thrombotic lesions or reduction of the cardiac function especially of the tricuspid valve could be shown and in the myocardium no cicatrices could be found. In the ECG no cardiac arrhythmia could be detected. In this case we decided to leave the atrial catheter in situ and follow the patient. Migration of atrial catheters is a rare but serious complication of VA-systems.

Results: In the follow-up both patients presented no headache, nausea or neurologic deficits.

Conclusions: The first step in such a case is to treat elevated intracranial pressure if present, then the dislocated catheter. In case of low risk of cardiac complications removal of the distal catheter seems not to be necessary.