Direct ventriculoatrial shunt in a pediatric patient: case report and technical note

Cyril S. Tankam, Varun Padmanaban, Julia Pazniokas, Jessica Lane, Joseph B. Clark, Elias B. Rizk

Research output: Contribution to journalArticlepeer-review


Background /importance: The safety of direct cardiac shunts has been historically described in the pediatric population before the introduction of silastic catheters but are rarely utilized in modern practice. Herein, we describe several technical nuances regarding the placement of a direct ventriculoatrial catheter in a pediatric patient, including the creation of a sternal divot to accommodate for the movement of the catheter during growth. Clinical presentation: We report a complex case of a 2-year-old former premature infant with multiple systemic congenital abnormalities, including tracheal atresia (type 2), complete atrioventricular septal defect status post repair, and shunted hydrocephalus. She developed multiple shunt malfunctions secondary to abdominal malabsorption and shunt infections. Conclusion: Multiple options for distal shunt placement, including the atrium via open and endovascular techniques, the abdomen, gallbladder, and pleura, were considered, but the direct cardiac placement was felt to be the safest option given the patient’s coexisting conditions. Placement requires a multidisciplinary team. Special consideration should be made for linear growth in children.

Original languageEnglish (US)
Pages (from-to)255-259
Number of pages5
JournalChild's Nervous System
Issue number1
StatePublished - Jan 2023

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology


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