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Ventriculopleural Shunt Placement in Children With Hydrocephalus: 30-Year Experience in a Single Institution: Presented at AANS By Kristina Rebelo SAN DIEGO -- May 8, 2009 -- Placement of ventriculopleural shunts for the treatment of hydrocephalus represents a safe alternative to ventriculoperitoneal and ventriculoatrial shunts in children age 8 years and older, according to results from the largest retrospective case-series study of ventriculopleural shunts in children, presented here at the 77th Annual Meeting of the American Association of Neurological Surgeons (AANS). Ventriculoperitoneal shunts remain the standard of care for the treatment of hydrocephalus; however, for older children who suffer abdominal infections, such as pseudocyst, adhesions, ruptured appendix, rare cases of gallbladder problems or peritonitis, ventriculopleural shunts are a viable alternative. "Particularly in patients with a history of multi-abdominal procedures with scar tissue, ventriculopleural shunts provide an invaluable efficacy assessment tool," stated lead author Parham Yasher, MD, Children's Hospital Los Angeles, affiliated with the Keck School of Medicine, University of Southern California, Los Angeles, California, speaking here on May 4. From 1977 to 2008, 105 hydrocephalic patients were treated with ventriculopleural shunts. Patients had a mean age of 13.59 +- 5.52 years; 61% were male. The leading presentation for the patient's hydrocephalus was myelomeningocele (33.3%), and patients with pseudocyst represented the most common indication for placement of a ventriculopleural shunt. In 47.8% of the patients, there were no complications; however, 14.5% of the patients developed a symptomatic pleural effusion. The median follow-up time for patients was 33 months. Twenty-five patients were lost, Dr. Yashar said, since they had reached their teenage or young-adult years, and no longer resided in the area. Revisions were required in 37% of patients, at a mean time of 19 months. The primary complication was due to shunt malfunction. "Given that nearly half of the patients in this series did not develop any complications from placement of ventriculopleural shunts, we believe that placement of these shunts for the treatment of hydrocephalus is a safe alternative to ventriculoperitoneal and ventriculoatrial shunts in children age 8 and older," Dr. Yashar concluded. [Presentation title: Ventriculopleural Shunts in Children: A Single Institution's 30-Year Experience. Abstract 633] E-mail this page to a friend or colleague! To print, use this version