What Is Ventriculoatrial Shunt Placement?

Ventriculoatrial shunting (VAS) is a procedure used to treat hydrocephalus that enables the cerebrospinal fluid (CSF) to flow from the brain to the heart's atrium.

Ventriculoatrial shunting (VAS)is a procedure that allows the cerebrospinal fluid (CSF) to flow from the brain to theatriumof theheart. This procedure is typically used to treat a condition calledhydrocephalus.

This condition occurs when there is excess CSF in the brain. CSF is a fluid that acts as a cushion for the brain, protecting the brain from an injury due to impact. The fluid also supplies nutrients to the brain and drains away waste products. The CSF normally flows through structures in the brain called the ventricles to the base of the brain and then continues to cover the brain and spinal cord after which the CSF gets absorbed back into the blood.

When the normal CSF flow is disrupted due to impact, there is an excess accumulation of fluid that increases the pressure on the brain (increased intracranial pressure/tension), leading to complications that can damage the brain. The goal of VAS is to divert the CSF away from the brain to theatrium, which is a chamber in the heart, hence reducing the intracranial pressure and restoring the normal CSF flow.

Ventriculoatrial shunting (VAS) placement is indicated for patients with hydrocephalus in whom other treatment modalities and procedures have failed.

Hydrocephalus occurs due to

• Obstruction(partial or complete obstruction of the normal flow of the cerebrospinal fluid [CSF]).
• Poor absorption(the blood vessels are unable to absorb the CSF due to inflammation of the brain or injury).
• Overproduction(CSF is created in excess and quickly compared to the absorption rate).
• Abnormal development of the central nervous system that can obstruct the flow of CSF.
• Lesions or tumors in the brain or spinal cord.
• Bleeding in the brain from astrokeorhead injury.

Hydrocephalus in newborns may be due to developmental abnormalities in the brain and nervous system, bleeding in the brain, and infection of the brain during birth.

Contraindications for ventriculoatrial shunting (VAS) placement include the following:

• Cerebrospinal fluid (CSF) infection
• Systemic infection
• Infection of the heart
• History of shunt-relatedkidney disease
• Pulmonary hypertension(increased官网地址bwinof the arteries in thelungsand right side of the heart)
• 心failure
• Bleeding disorders

ventriculoatrial分流安置涉及steps to the procedure, as outlined below.

Before the procedure

医生执行一个完整的物理examination. They perform a complete blood analysis and radiological assessment of the brain.

Anesthesia

The procedure is performed after the patient is given general anesthesia.

During the procedure

The ventriculoatrial shunt is performed under radiological guidance, by placing the tip of a catheter in the ventricle of the brain. The other end of the catheter is placed in theatriumof the heart. The catheter with a valve functions as a unidirectional medium, draining the excess fluid from the brain to the heart. In the heart, the fluid mixes with the blood and gets absorbed.

After the procedure

The patient is administered with intravenous antibiotics and painkillers. Radiological assessment is done after the procedure to ensure that the catheter is positioned correctly.

Complications of ventriculoatrial shunting (VAS) placement may include the following:

• Shunt-induced inflammation of the kidneys
• Microemboli (blood clotsin the blood vessels)
• Pulmonary hypertensiondue to microemboli
• Thrombosis (blood clots) in larger blood vessels
• Endocarditis(inflammation of the heart)
• Wound/cerebrospinal fluid (CSF) shunt infection
• Outgrowing the shunt (as a child with VAS grows, shunt malposition occurs, leading to shunt malfunction)
• Arrhythmia (irregular heartbeat)
• Shunt malfunction
• Delayed intracranial hemorrhage (bleeding into the brain)