ventriculoatrial

Ventriculoatrial refers to a type of cerebrospinal fluid shunt in which fluid is drained from the brain's ventricles into the right atrium of the heart. It is one of several routes used to treat hydrocephalus, a condition characterized by excessive accumulation of cerebrospinal fluid. VA shunts were more commonly used in the past and remain an option when other drainage sites are unsuitable.

In a ventriculoatrial shunt, a catheter is placed into a cerebral ventricle, typically the lateral ventricle, and a distal catheter is advanced through the venous system to reach the right atrium. Valves or anti-siphon devices may be included to regulate flow and to reduce overdrainage. Because the distal end resides in the cardiovascular system, VA shunts require careful consideration of potential systemic complications.

Potential advantages of VA shunts include avoiding peritoneal complications when the abdomen is not suitable for shunt placement, such as extensive adhesions, infection, or ascites. However, they carry distinct risks, including infection that can involve the heart, endocarditis, atrial thrombosis, pulmonary embolism, arrhythmias, and congestive heart failure. Shunt malfunction or obstruction can occur at either the ventricular or atrial ends, leading to recurrence of hydrocephalus.

VA shunts have declined in use in favor of ventriculoperitoneal shunts, which are generally easier to manage and carry different risk profiles. VA shunts may still be chosen in select patients when peritoneal drainage is contraindicated or has failed, with ongoing monitoring by neuroimaging and clinical evaluation to manage potential complications.