title: Minimally invasive echo-guided placement of the cardiac tube in a ventriculoatrial shunt during pregnancy: technical note.
abstract: 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.
authors: Department of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors: Licia
authors: L
authors: Di Muro
authors: Roberto
authors: R
authors: Pallini
authors: Domenico
authors: D
authors: Pietrini
authors: Christian
authors: C
authors: Colizzi
authors: Luca
authors: L
authors: Denaro
mesh_terms: 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