Percutaneous construction of ventriculo-atrial (VA) shunt - Case report.

Autor:	Ugwuanyi UC; Neurosurgery Unit, Department of Surgery National Hospital Abuja, Nigeria; Wellington Neurosurgery Centre Abuja, Nigeria., Anumenechi N; Cardiovascular Surgery Unit, Department of Surgery National Hospital Abuja, Nigeria., Salawu MN; Department of Anaesthesia, National Hospital Abuja, Nigeria., Okpata CI; Neurosurgery Unit, Department of Surgery National Hospital Abuja, Nigeria., Onobun DE; Wellington Neurosurgery Centre Abuja, Nigeria. Electronic address: danielonobun@gmail.com., Adeoti EO; Wellington Neurosurgery Centre Abuja, Nigeria.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2022 Oct; Vol. 99, pp. 107651. Date of Electronic Publication: 2022 Sep 13.
DOI:	10.1016/j.ijscr.2022.107651
Abstrakt:	Introduction and Importance: The commonest method of elective CSF diversion remains ventriculo-peritoneal shunt (VP shunt). But in some circumstances, VP shunts fail repeatedly or becomes unattractive to the neurosurgeon and this calls for exploration of alternatives. For the index case, Ventriculo-atrial (VA) shunt was favoured and the objective in this report is to share experience gathered there from. Learning points serve to highlight the use of VA shunts as a resort in the drainage of cerebrospinal fluid in the case of repeated failures of peritoneal diversion of CSF and to explain our explain our experience with this index case. Case Presentation: A 54 years old obese woman with previous history of total abdominal hysterectomy was reported. She underwent repeated (three times) revisions of failed peritoneal end of her VP shunt on a background of obstructive hydrocephalus secondary to a posterior fossa tumour (previously excised). Following repeated failure of peritoneal catheter function, she underwent VA shunt and did well. Clinical Discussion: The decision to place a VA shunt was made after careful deliberations. We discuss the peculiarities in placing a VA shunt. Following placement of a VA shunt, improvement was noted in her clinical condition at one week post op and has been sustained at multiple follow up clinic visits. Conclusion: VA shunts become an option for cerebrospinal fluid drainage when it becomes unequivocally clear in a multidisciplinary setting that the peritoneal catheter is unlikely to work in view of the unfavourable circumstances of the peritoneal cavity. Competing Interests: Declaration of competing interest The authors report no conflict of interest. (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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