ventriculopleural

A ventriculopleural shunt is a cerebrospinal fluid (CSF) diversion system that drains fluid from the cerebral ventricles into the pleural cavity. It is used when the peritoneal cavity is unsuitable for CSF absorption or has contraindications, such as extensive abdominal adhesions, infection, ascites, or prior shunt failure.

The device consists of a ventricular catheter, a valve, and a distal catheter that terminates in the pleural space. CSF flows from the ventricle through the catheter into the pleural cavity, where it is absorbed by the pleural lymphatic system. The valve helps regulate flow to minimize overdrainage and related complications.

Indications include hydrocephalus due to obstruction or shunt malfunction when a ventriculoperitoneal shunt is not feasible. It may be considered in adults or children when peritoneal absorption is limited or contraindicated, or after other distal sites have failed or been exhausted.

Risks and complications include pleural effusion or hydrothorax, pneumothorax, infection, catheter obstruction or disconnection, and catheter migration. Overdrainage can lead to subdural collections or headaches. Pleural complications such as empyema or pleuritis may occur, and local chest wall issues can arise with long-term device use.

Outcomes vary with patient factors and pleural space tolerance. Ventriculopleural shunts can be effective alternatives when other distal sites are unsuitable, but ongoing monitoring is required to detect drainage problems, pleural fluid accumulation, or shunt-related infection. Conversion to another distal site may be necessary in some cases.