Distal ventriculoperitoneal shunt catheter migration to the right ventricle of the heart--a case report.

Ventriculoperitoneal shunts (VPS) have few complications other than mechanical obstruction and infection. A VPS catheter located in the chest is a rare complication, while intracardiac catheter migration is rarer still. We present a case of intracardiac migration of a distal VPS catheter after initial documented peritoneal placement. Puncture or erosion of a cervical vein may predispose a patient to such a migration. Negative inspiratory pressure and orthograde blood flow may then draw the catheter proximally through a vein and eventually to the heart or pulmonary artery. We discuss the mechanisms and management of this rare, yet dangerous, complication of a routine neurosurgical procedure.