A consecutive series of 120 patients with infantile hydrocephalus who
were submitted to ventriculo-atrial shunting was studied. The average
follow-up was 11 years. There was no operative mortality; 7 patients d
ied during the follow-up period, but only in 1 case was the cause of d
eath a consequence of the shunt procedure. The incidence rates of infe
ction and slit ventricle syndrome were 4.2% and 1.8%, respectively. Sh
unt revision was performed on 253 occasions yielding a revision rate o
f 2.2 per patient. Of these 253 revisions 167 (66%) took the form of e
lective lengthening of the atrial catheter. The number of reoperations
to adjust the length of the atrial catheter or to revise the distal e
nd of the shunting system is a major disadvantage, which actually favo
rs ventriculo-peritoneal shunting as the primary procedure for the tre
atment of pediatric hydrocephalus.