The transcervical cardiac catheter: its transverse pretracheal placement in the treatment of cardiac catheter complications with ventriculo-atrial shunts in infantile hydrocephalus.

In 40 hydrocephalic children with ventriculo-atrial shunts 58 operative revisions of the cardiac catheter were evaluated. The review of the patients with cardiac catheter complications showed that the majority (68%) had undergone the primary shunting procedure as newborn or as prematurely born within the first 6 months of life. Most frequently the revisions had become necessary because of obstruction of the cardiac catheter at its distal end (22 times) and the slipping of the catheter from the valve (21 times). Other revisions were carried out for too long (2 times) or too short (once) cardiac catheter, rupture (5 times), kinking or coiling (7 times) of the catheter. The transcervical cardiac catheter, which was given particular attention, used for insertion in revisions for venous obliteration on the side of the previous catheter placement, was performed in 11 patients. It yielded good results in respect of practicability and prognosis and can be recommended as a useful method for shunt revision in venous obstruction.