Percutaneous placement of ventriculoatrial shunts in the pediatric population

The percutaneous placement of ventriculoatrial (VA) shunts has been previou sly described, usually in adults. We report a series of 7 pediatric cases r anging from 6 to 17 years, Five patients were female and 2 were male. All p atients had prior ventriculoperitoneal (VP) shunts for hydrocephalus, of wh ich 1 had been subsequently converted to a ventriculopleural shunt. Indicat ions for conversion to a VA shunt were intra-abdominal infection in 6 cases and chronic pleuritic chest pain in 1 patient. The venous entry was the su bclavian vein in all cases. All patients have remained asymptomatic since t he operation. There were no complications associated with the procedures, w ith follow-up ranging from 2 to 12 months. This technique is a viable alter native to the open cervical approach for venous entry to the right atrium i n the pediatric population.