J Korean Neurosurg Soc.  2008 Sep;44(3):170-173. 10.3340/jkns.2008.44.3.170.

Upward Migration of Distal Ventriculoperitoneal Shunt Catheter into the Heart : Case Report

• Chong JY
• Kim JM
• Cho DC
• Kim CH

• KMID: 2067350
• DOI: http://doi.org/10.3340/jkns.2008.44.3.170

Abstract

Ventriculoperitoneal (VP) shunt is commonly and effectively used to treat hydrocephalus. Intracardiac migration of the shunt catheter is a rare complication. A 68-year-old woman underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to anterior communicating artery aneurysm rupture. Two weeks after the shunt surgery, she had suffered from the abdominal pain. Plain chest x-rays, computed tomography, and echocardiography revealed the distal catheter which was in the right ventricle of the heart. We tried to remove the catheter through the internal jugular vein by fluoroscopic guidance. But, the distal catheter was kinked and knotted; therefore, we failed to withdraw the catheter. After then, we punctured the right femoral vein and pulled down the multi-knotted shunt catheter to the femoral vein using the snare catheter. Finally, we removed the knotted distal catheter via the femoral vein and a new distal catheter was placed into the peritoneal cavity. We report a case in which the distal catheter of the VP shunt migrated into the heart via the internal jugular vein. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.

Keyword

Ventriculoperitoneal shunt; Distal catheter; Internal jugular vein; Heart; Hydrocephalus

MeSH Terms

Abdominal Pain
Aged
Catheters
Echocardiography
Female
Femoral Vein
Heart
Heart Ventricles
Humans
Hydrocephalus
Intracranial Aneurysm
Jugular Veins
Peritoneal Cavity
Rupture
SNARE Proteins
Subarachnoid Hemorrhage
Thorax
Ventriculoperitoneal Shunt
SNARE Proteins