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

 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.  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.  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.  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.  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.