The Anesthesiologist's Role in a Ventriculoatrial Shunt

Ventricular shunts are commonly performed for the treatment for hydrocephalus; they divert the CSF accumulated in the ventricles to an extra-cranial space. When the most common of these, the ventriculoperitoneal shunt, fails... [ view full abstract ]

Ventricular shunts are commonly performed for the treatment for hydrocephalus; they divert the CSF accumulated in the ventricles to an extra-cranial space. When the most common of these, the ventriculoperitoneal shunt, fails or is no longer an option, a ventriculoatrial shunt should be considered. Whether it be due to surgeon inexperience or our experience with obtaining central access, anesthesiologists may be called upon to assist with such a procedure. In this case report, we discuss a patient whose ventriculoperitoneal shunt became infected, necessitating an alternative to his hydrocephalus. Once the surgeons decided to place a ventriculoatrial shunt, our assistance was requested in cannulating the internal jugular vein, where the shunt catheter would reside. Our role is also valuable in confirming the placement of the catheter, possibly via transesophageal echocardiography, and in understanding the complications of ventriculoatrial shunts when managing patients with them in a perioperative or intensive care unit setting.