Abstract
The more troublesome problems encountered in the care of 143 hydrocephalic children with ventriculocardiac shunts are reviewed to determine the nature of these shunts and to suggest methods for improvement. Ninety-four patients had mechanical shunt difficulties requiring about 350 operations; 41 developed postoperative meningitis or sepsis, 10 had serious cardiopulmonary complications, and 42 are dead. Although 38 have significant mental retardation, paraplegia, or similar serious defects and are “noncompetitive”, 49 have progressed well, are bright, and appear normal or nearly so. About 10 of these are no longer shunt dependent. Difficulties were fewer and results better in the latter half of the 15 year span covered by this study. It seems clear that improved results can be obtained in shunt patients by careful selection and meticulous diagnostic and surgical techniques, but long-range surveillance will continue to ge essential.
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