Long-Term Outcomes in Ventriculoatrial Shunt Surgery in Patients with Pediatric Hydrocephalus: Retrospective Single-Center Study
| Autor: | Andreas Gruber, Willem J.R. van Ouwerkerk, Wolfgang Thomae, Matthias Gmeiner, Gracija Sardi, Kurt Holl, Wolfgang Senker, Helga Wagner |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Shunt nephritis Single Center Ventriculoperitoneal Shunt Asymptomatic Time Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Humans Medicine Child Retrospective Studies Ventriculoatrial shunt business.industry medicine.disease Shunt (medical) Surgery Hydrocephalus Catheter Treatment Outcome 030220 oncology & carcinogenesis Etiology Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | World Neurosurgery. 138:e112-e118 |
| ISSN: | 1878-8750 |
| Popis: | Objective Long-term outcomes are rarely reported for patients with pediatric hydrocephalus. Ventriculoperitoneal shunting is the surgical standard; nevertheless, in selected patients, a ventriculoatrial shunt (VAS) remains an important alternative. This study aimed to analyze the causes of VAS revisions and complications. Methods Pediatric patients who underwent their first shunt operation between 1982 and 1992 were included. The timing, cause, and modality of VAS revisions were retrospectively determined. Results Overall, 138 patients were treated for hydrocephalus and 61 patients received a VAS during the follow-up period. A primary VAS was the first shunt type in 42 (68.85%) patients. In 19 (31.15%) patients, conversions to second-line VAS were carried out. The rates of VAS revisions performed for dysfunction or elective lengthening of a short atrial catheter were 52.2% and 22.9%, respectively. There was no difference in the number of VAS revisions between patients with primary VASs and second-line VASs. Age at VAS and etiology of hydrocephalus had no effect on the number of revisions. Specific VAS complications were observed in 2 patients. Deep positioning of the distal catheter led to asymptomatic tricuspid regurgitation that was reversible after shortening of the atrial catheter. Another patient presented with shunt nephritis and completely recovered after the atrial catheter was replaced with a peritoneal catheter. Conclusions VAS remains an appropriate second-line alternative in selected patients. Specific VAS complications were rarely observed and completely reversible after treatment. However, regular and specific follow-up examinations are strongly recommended to avoid cardiopulmonary or renal complications. |
| Databáze: | OpenAIRE |
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