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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(01): 088-094
DOI: 10.1055/s-0044-1795165
Original Article

Should Not Children with Ventriculoatrial Shunts Be Taking Aspirin? An Update: 0% Distal Malfunction

Suhas Udayakumaran
1   Division of Paediatric Neurosurgery, Department of Neurosurgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, India
,
Shine Kumar
2   Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, India
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Funding None.
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Abstract

Background Ventriculoatrial (VA) shunts have the potential to preserve life in the event of failure of ventriculoperitoneal (VP) shunts. Contrary to VP shunts, they are susceptible to consequences, particularly cardiac problems. There are no established guidelines for screening patients following VA shunt placement regarding prevention, anticoagulant treatment, or risk factor screening.

Objective We aim to investigate aspirin's potential function and effectiveness in enhancing shunt survival and preventing secondary morbidity from distal thrombosis in children with VA shunts.

Materials and Methods The study's design is prospective and observational. It began in 2011 and is ongoing. Before inclusion in the study, we obtained clearance from the hospital ethics board and consent from the family. All patients with VA shunts were given a once-a-day antiplatelet dose of 5 mg/kg of aspirin from the first postoperative day. The study's primary end points include: (1) Major distal end malfunction documented on echocardiography or (2) any cardiac complications directly associated with the VA shunt.

Results Since March 2011, 13 patients have been followed up. So far, no cardiac complications have been ascribed to VA shunts in any of the patients. The current follow-up period is 28 to 170 months. Patient follow-up is continuing.

Conclusion Our observations regarding the efficacy and safety of aspirin in VA shunts are encouraging. However, sufficient time would be needed to establish its effectiveness in chronic sequelae such as pulmonary hypertension.

Keywords

silicone - complications - thromboprophylaxis

Note

This study was previously presented as a platform presentation at ISPN 2023, held at Vina de la Mer, Chile.


Authors' Contributions

S.U. contributed to the concept, study design, statistics, drafting, and final revision. S.K. contributed to the concept and final revision.


Ethical Approval

This study protocol was reviewed and approved by the Institutional Ethics Committee, AIIMS, approval number IECAIMS 22200-2019.




Publication History

Article published online:
21 November 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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