Online first
View Point
Published online: 2024-06-12

open access

Page views 164
Article views/downloads 87
Get Citation

Connect on Social Media

Connect on Social Media

Migration of atrial catheter of ventriculo-cysto-atrial shunt into heart and pulmonary artery — case report and literature review

Václav Vybíhal1, Martin Plevko12, Pavel Fadrus12, Martin Smrčka12, Marek Sova12, Martin Poloczek34, Miloš Keřkovský56


Ventriculoatrial shunts are the alternative treatments when it is impossible to use ventriculoperitoneal shunts. Limited indication for ventriculoatrial shunt is due to the possibility of very serious complications inherent with this procedure. We present a case report of a young patient who suffered from disconnection of an atrial catheter from the valve after an accidental blow to his neck. The atrial catheter was dislocated to the heart and pulmonary artery and it was extracted through the femoral vein in the groin area using an endovascular technique. The procedure went without complications. A new atrial catheter was introduced under ultrasonic guidance during surgical revision.

Article available in PDF format

View PDF Download PDF file


  1. Nowosławska E, Moszura T, Mikołajczyk-Wieczorek W, et al. A hybrid technique for ventriculoatrial shunt implantation--technical note. Childs Nerv Syst. 2014; 30(10): 1729–1732.
  2. Yavuz C, Demırtas S, Calıskan A, et al. Reasons, procedures, and outcomes in ventriculoatrial shunts: A single-center experience. Surg Neurol Int. 2013; 4: 10.
  3. Gopal VV, Peethambaran AK. Rare sequelae following ventriculoatrial shunt: Case report and review of literature. Asian J Neurosurg. 2016; 11(2): 173.
  4. Vernet O, Rilliet B. Late complications of ventriculoatrial or ventriculoperitoneal shunts. Lancet. 2001; 358(9293): 1569–1570.
  5. Elhammady MS, Benglis DM, Bhatia S, et al. Ventriculoatrial shunt catheter displacement in a child with partial anomalous pulmonary venous return: case report. J Neurosurg Pediatr. 2008; 2(1): 68–70.
  6. Hanak BW, Bonow RH, Harris CA, et al. Cerebrospinal Fluid Shunting Complications in Children. Pediatr Neurosurg. 2017; 52(6): 381–400.
  7. Nash D, Schmidt K. Complications and management of ventriculoatrial (VA) shunts, a case report. Cerebrospinal Fluid Research. 2010; 7(S1).
  8. Natarajan A, Mazhar S. Right heart complications of ventriculoatrial shunt. Eur Heart J. 2011; 32(17): 2134.
  9. Mori T, Arisawa M, Fukuoka M, et al. Management of a broken atrial catheter migrated into the heart: a rare complication of ventriculoatrial shunt--case report. Neurol Med Chir (Tokyo). 1993; 33(10): 713–715.
  10. Pradini-Santos L, Craven CL, Watkins LD, et al. Ventriculoatrial Shunt Catheter Tip Migration Causing Tricuspid Regurgitation: Case Report and Review of the Literature. World Neurosurg. 2020; 136: 83–89.
  11. O'Shea PA. Inferior vena cava and hepatic vein thrombosis as a rare complication of ventriculoatrial shunt. Case report. J Neurosurg. 1978; 48(1): 143–145.
  12. Hung AL, Vivas-Buitrago T, Adam A, et al. Ventriculoatrial versus ventriculoperitoneal shunt complications in idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg. 2017; 157: 1–6.
  13. Yurtseven T, Erşahin Y, Kitiş O, et al. Thrombosis and thrombophilebitis of the internal jugular vein as a very rare complication of the ventriculoatrial shunt. Clin Neurol Neurosurg. 2005; 107(2): 144–146.
  14. Tatsumi T, Howland WJ. Retrieval of a ventriculoatrial shunt catheter from the heart by a venous catheterization technique. Technical note. J Neurosurg. 1970; 32(5): 593–596.
  15. Fewel ME, Garton HJL. Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature. J Neurosurg. 2004; 100(2 Suppl Pediatrics): 206–211.
  16. Morell RC, Bell WO, Hertz GE, et al. Migration of a ventriculoperitoneal shunt into the pulmonary artery. J Neurosurg Anesthesiol. 1994; 6(2): 132–134.
  17. Holden TM, Crow ML. Free intracardiac foreign body: A complication of ventriculovenous shunt for hydrocephalus. J Thorac Cardiovasc Surg 45: 138. 1963; 45: 138–140.
  18. Imamura H, Nomura M. Migration of ventriculoperitoneal shunt into the heart--case report. Neurol Med Chir (Tokyo). 2002; 42(4): 181–183.
  19. Kubo S, Takimoto H, Takakura S, et al. Peritoneal shunt migration into the pulmonary artery--case report. Neurol Med Chir (Tokyo). 2002; 42(12): 572–574.
  20. Chuang HL, Chang CN, Hsu JC. Minimally invasive procedure for ventriculoatrial shunt-combining a percutaneous approach with real-time transesophageal echocardiogram monitoring: report of six cases. Chang Gung Med J. 2002; 25(1): 62–66.
  21. Gonzalez LF, Kim L, Rekate HL, et al. Endovascular placement of a ventriculoatrial shunt. Technical note. J Neurosurg. 2007; 106(4 Suppl): 319–321.
  22. Metellus P, Hsu W, Kharkar S, et al. Accuracy of percutaneous placement of a ventriculoatrial shunt under ultrasonography guidance: a retrospective study at a single institution. J Neurosurg. 2009; 110(5): 867–870.
  23. Vernet O, Rilliet B. Late complications of ventriculoatrial or ventriculoperitoneal shunts. Lancet. 2001; 358(9293): 1569–1570.
  24. Akhtar N, Khan AA, Yousaf M. EXPERIENCE AND OUTCOME OF VENTRICULAR-ATRIAL SHUNT: A MULTI CENTRE STUDY. J Ayub Med Coll Abbottabad. 2015; 27(4): 817–820.
  25. James CA, McFarland DR, Wormuth CJ, et al. Snare retrieval of migrated ventriculoatrial shunt. Pediatr Radiol. 1997; 27(4): 330–332.
  26. So A, Shirani J. Pulmonary artery embolization of ventriculoatrial shunt fragment. Tex Heart Inst J. 2009; 36(2): 184–185.
  27. Irie W, Furukawa M, Murakami C, et al. A case of V-A shunt catheters migration into the pulmonary artery. Leg Med (Tokyo). 2009; 11(1): 25–29.
  28. Matsubara N, Miyachi S, Tsukamoto N. [Intracardiac migration of a ventriculoatrial shunt catheter treated by endovascular transvenous retrieval]. No Shinkei Geka. 2012; 40(6): 539–545.
  29. Aloddadi M, Alshahrani S, Alnaami I. Endovascular Retrieval of Detached Ventriculoatrial Shunt into Pulmonary Artery in Pediatric Patient: Case Report. J Pediatr Neurosci. 2018; 13(1): 78–80.
  30. Xu J, Morchi G, Magge SN. Endovascular retrieval of a broken distal ventriculoatrial shunt catheter within the heart: illustrative case. J Neurosurg Case Lessons. 2021; 2(21): CASE21452.
  31. López Sánchez M, Domínguez Artiga MJ, Ortiz Lasa M, et al. Ventriculoatrial catheter migration. Med Intensiva (Engl Ed). 2020 [Epub ahead of print]; 46(5): 296.
  32. Zervos TM, Kutschman K, Frisoli T, et al. Techniques for management and avoidance of ventriculoatrial shunt disconnection: illustrative cases. J Neurosurg Case Lessons. 2022; 3(22): CASE21654.