PERCUTANEOUS TRANSVENOUS REMOVAL OF A PUDENZ-HEYER CATHETER FRAGMENT FROM THE PULMONARY-ARTERY

A ventriculo-atrial shunt had been placed 3 years previously in a now 17-year-old boy because of obstructive hydrocephalus of unknown cause. He presented with symptoms of elevated cerebrospinal fluid pressure and computed tomography demonstrated a dilatated ventricular system. The chest X-ray film revealed a break in the shunt catheter at the level of the right clavicle with embolization of its 13 cm long distal part into the main stem and right branch of the pulmonary artery. The fragment was retrieved without complication with a percutaneously and transvenously introduced basket catheter. - Centrally embolized catheter fragments should be removed as soon as possible. The percutaneous route is well tolerated by and of low risk for the patient. It should always be attempted before any surgical intervention.