Echocardiographic detection of intracardiac thrombi complicating ventriculo-atrial shunt. Report of two cases.

Right atrial thrombi are rare but serious complications of ventriculoatrial (VA) shunts. Two hydrocephalic patients who received a VA shunt developed thromboembolic complications. The initial manifestation was malfunction of the distal end of the shunt and right heart failure. Bidimensional echocardiography demonstrated an intracardiac mass on the distal intra-auricular end of the shunt. Pulmonary scan showed multiple emboli even in the asymptomatic patient. This demonstrates the important role of bidimensional echography as a noninvasive diagnostic technique for this particular complication of a VA shunt. Medical and surgical treatment modalities are discussed.