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Calcified Thrombus of the Superior Vena Cava Complication of Ventriculoatrial Shunt

Orlando F. Gabriele, MD; Daniel Clark, MD
Am J Dis Child. 1969;117(3):325-327. doi:10.1001/archpedi.1969.02100030327014.
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SINCE 1957 when Pudenz successfully shunted the cerebral ventricles to the right atrium, similar procedures have been performed numerous times for the treatment of hydrocephalus. Complications of ventriculoatrial shunt1 include the following: (1) perforation of cardiac muscle, (2) embolic detached tube, (3) occlusion of the shunt, (4) bacterial endocarditis, (5) thrombosis of the superior vena cava or thrombus formation in the right atrium, (6) pulmonary embolism, and (7) infection with meningitis or septicemia. Thromboembolism is a frequent complication of this procedure, and partial or complete obstruction of the superior cardiac inflow channels is not uncommon. This complication is usually manifest as a poorly functioning shunt with increasing intracranial pressure. Manipulation of the shunt valve may indicate occlusion of the distal extremity. An angiogram may demonstrate thrombosis of the superior vena cava and the concomitant collaterals. Plain roentgenograms of the chest may, on occasion, show a fractured shunt tube as


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