Minimally invasive echo-guided placement of the cardiac tube in a ventriculoatrial shunt during pregnancy: technical note.
OBJECTIVE
We describe a minimally invasive echo-guided placement of the cardiac tube in a ventriculoatrial shunt in a young pregnant woman, in order to avoid any radiological procedure.


METHODS
We used a central venous catheter placement kit for percutaneous echo-guided right internal jugular vein puncture located by a 7.5 mHz microlinear probe. Through the catheter, the distal portion of the shunt device was positioned into the internal jugular vein to the right atrium using ultrasound control by a 2.5 to 3.5 mHz probe in a four-chamber transthoracic view.


RESULTS
Sonographic guidance in percutaneous placement of a vertebral artery shunt is a safe and fast minimally invasive technique that improves success rates and decreases complications such as incidental puncture of the carotid artery and pneumothorax. The use of a two-dimensional echocardiographic apparatus in a four-chamber transthoracic view is an accurate and simple method to verify the position of the distal tip of the shunt in the mid-right atrium with no risks for the patient.


CONCLUSIONS
The use of these two techniques allows a minimally invasive, safe, accurate, and complete x-ray-free procedure.
Di Muro
Licia
L
Department of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
Pallini
Roberto
R
Pietrini
Domenico
D
Colizzi
Christian
C
Denaro
Luca
L
D000328:Adult; D002405:Catheterization, Central Venous / Q000379:methods*; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D011247:Pregnancy