Britz G W, Avellino A M, Schaller R, Loeser J D
Department of Neurosurgery, University of Washington School of Medicine, Wash., USA.
Pediatr Neurosurg. 1998 Sep;29(3):161-3. doi: 10.1159/000028713.
The percutaneous placement of ventriculoatrial (VA) shunts has been previously described, usually in adults. We report a series of 7 pediatric cases ranging from 6 to 17 years. Five patients were female and 2 were male. All patients had prior ventriculoperitoneal (VP) shunts for hydrocephalus, of which 1 had been subsequently converted to a ventriculopleural shunt. Indications for conversion to a VA shunt were intra-abdominal infection in 6 cases and chronic pleuritic chest pain in 1 patient. The venous entry was the subclavian vein in all cases. All patients have remained asymptomatic since the operation. There were no complications associated with the procedures, with follow-up ranging from 2 to 12 months. This technique is a viable alternative to the open cervical approach for venous entry to the right atrium in the pediatric population.
经皮心室-心房（VA）分流术此前已有报道，通常用于成人。我们报告了一系列7例年龄在6至17岁的儿科病例。其中5例为女性，2例为男性。所有患者此前均因脑积水接受过脑室-腹腔（VP）分流术，其中1例随后转换为脑室-胸膜分流术。转换为VA分流术的指征为6例腹腔内感染和1例慢性胸膜炎性胸痛。所有病例的静脉入路均为锁骨下静脉。自手术以来，所有患者均无症状。这些操作未出现并发症，随访时间为2至12个月。对于儿科患者经颈部开放入路进入右心房的静脉入路而言，该技术是一种可行的替代方法。
