[Intracardiac migration of a ventriculoperitoneal shunt. A systematic literature review and case report].

Abstract

CSF shunting procedures are common in neurosurgery. A rare complication of these procedures is migration of distal catheter. We present a case of peritoneal catheter migration into the right heart chambers. A systematic review of appropriate literature data was carried out.

Material and methods: We present a patient with communicating hydrocephalus after previous penetrating traumatic brain injury. Migration of peritoneal catheter into the right heart chambers occurred in 5 days after ventriculoperitoneal shunting. We performed a systematic review of literature data and analyzed all similar cases of intracardiac migration of ventriculoperitoneal catheter, risk factors of migration, possible complications and surgical treatments.

Results: There were 38 articles describing 40 cases of distal catheter migration into the right heart chambers meeting the inclusion criteria. In 65% of patients, catheter migration was diagnosed after ≥2 months. Migration was asymptomatic in 21% of cases. Additionally, less than 50% of patients had no complications. Surgical treatment required complex techniques such as endovascular removal or thoracotomy in nearly 50% of cases.

Conclusion: Migration of ventriculoperitoneal catheter into the right heart chambers is a rare and dangerous complication of CSF shunting procedures. Risk factors of this complication should be considered when scheduling surgical treatment and follow-up examinations.