Thromboembolism Complicating Holter Valve Shunt

For the past 2½ years, most of the patients with hydrocephalus at the University of Michigan Medical Center have been surgically treated by establishing a ventriculovenous shunt between a lateral ventricle of the brain and the right atrium of the heart. The Holter valve has been employed in the procedure, and is designed to prevent backflow of blood into the ventricular system. Carrington1has reported the results of the first 50 of these procedures. The purpose of this report is to call attention to the possible risk of fatal thromboembolism, a rare pediatric problem, as a complication of the shunt procedure. Material and Method The 4 patients in this series were hospitalized on the service of the Department of Pediatrics and Communicable Diseases, and were operated upon by members of the Department of Neurosurgery. Necropsies were performed in the Department of Pathology. The Holter valve was surgically utilized in