[Thromboembolism as a complication of Pudenz-Heyer drainage with cardiac shunt].

We report the case of a 2.7 year old boy with ventriculoatrial Pudenz Heyer shunt for hydrocephalus internus presenting with symptoms suggestive of shunt infection. 2D-echocardiography showed a pedunculated right atrial thrombus that prolapsed through the tricuspid valve in diastole. Scintigraphy of the lungs showed multiple defects suggestive of embolism. The thrombus was excised after exploratory surgery with cardiopulmonary bypass. No organisms could be isolated from the thrombus. In ventriculo-atrial Pudenz Heyer shunt thrombi and embolism are possible complications. The regular use of 2D-echocardiography in order to detect these thrombi at a very early stage is discussed.