Migration of a distal shunt catheter into the heart and pulmonary artery: report of a case and review of the literature.

INTRODUCTION: A rare complication of ventriculoperitoneal shunt placement is the proximal migration of the distal catheter into the heart and pulmonary artery. There have been 12 reported cases regarding intracardiac migration. In five of the cases, the catheter traveled further into the pulmonary vasculature. CASE REPORT: The authors report another case regarding the latter situation where the catheter tip localized in a right upper lobe pulmonary arterial branch. Removal of the catheter was complicated by redundancy of the catheter and a knot along the catheter. Nevertheless, extraction was successful via endovascular retrieval using interventional radiology and loop snares. Catheter migration likely began where the right internal jugular vein was penetrated during the initial shunt placement. Subsequent venous flow and negative intrathoracic pressure coordinated the proximal migration of the catheter. The authors provide a literature review to provide information regarding management of this rare complication.