Minimally invasive procedure for ventriculoatrial shunt-combining a percutaneous approach with real-time transesophageal echocardiogram monitoring: report of six cases.

To make the ventriculo atrial (VA) shunt procedure less invasive and avoid atrial catheter malpositioning, we combined a percutaneous approach with transesophageal echocardiogram (TEE) to monitor the atrial catheter tip. From July 1995 to October 1996, we performed 6 VA shunt procedures by combining these 2 techniques. Except for one patient who had a concomitant Port-A catheter, which obscured the detection of TEE in the procedure, all other atrial catheters achieved ideal positioning and good function. The mean operation time was shorter, and the complications were fewer than those using the conventional procedure in our hospital. In addition to this particular aspect, by combining these 2 techniques, the VA shunt procedure can be performed much less invasively, but more accurately, quickly, and safely.