<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1608-8921</journal-id>
<journal-title><![CDATA[Gaceta Médica Espirituana]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Méd Espirit]]></abbrev-journal-title>
<issn>1608-8921</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Sancti Spíritus]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1608-89212024000100022</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Inserción de derivación ventrículo-atrial guiada por fluoroscopia]]></article-title>
<article-title xml:lang="en"><![CDATA[Fluoroscopy guided ventriculo-atrial shunt insertion]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Horta-Tamayo]]></surname>
<given-names><![CDATA[Ernesto Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acosta-González]]></surname>
<given-names><![CDATA[Luis Cesar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Alonso]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Hernández]]></surname>
<given-names><![CDATA[Enrique Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Clínico Quirúrgico &#8220;Lucía Iñiguez Landín&#8221;  ]]></institution>
<addr-line><![CDATA[ Holguín]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>26</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1608-89212024000100022&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1608-89212024000100022&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1608-89212024000100022&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamento: La derivación ventrículo-atrial se realiza de manera habitual para el tratamiento de la hidrocefalia cuando la derivación ventrículo-peritoneal ha fallado o los pacientes presentan alguna enfermedad intraabdominal que contraindica el peritoneo como destino ideal. Durante la cirugía, la colocación del extremo distal del catéter en la unión cavo-atrial es esencial en la prevención de posibles complicaciones.  Objetivo:  Describir las características clínicas de un paciente que recibió derivación ventrículo-atrial guiada por fluoroscopia.  Presentación de caso:  Femenina, de 26 años, manualidad derecha con antecedentes de hidrocefalia comunicante posmeningítica en la infancia, por la cual se le realizó derivación ventrículo-peritoneal. Sufrió múltiples reintervenciones por obstrucción del catéter. Comenzó con signos de hipertensión intracraneal por lo que se exterioriza el catéter, con desaparición de los síntomas. Se recoloca en la transcavidad de los epiplones y presenta reaparición de los síntomas neurológicos, síndrome peritoneal y seudoquistes en la ecografía abdominal. Se decidió realizar derivación ventrículo-atrial con el método fluoroscópico para garantizar posición ideal. Se ha mantenido con tratamiento antiagregante y seguimiento ecocardiográfico y radiológico, sin complicaciones.  Conclusiones:  La derivación ventrículo-atrial es una opción cuando la derivación ventrículo-peritoneal está contraindicada. La utilización de la fluoroscopia transoperatoria permite la colocación óptima del extremo distal del catéter. La ecocardiografía seriada posibilita la detección temprana de posibles complicaciones y el tratamiento antiagregante contribuye a disminuir las de origen intravascular.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background:  The ventriculo-atrial shunt is performed routinely for the treatment of hydrocephalus when the ventriculo-peritoneal shunt has failed or patients present some intra-abdominal disease that contraindicates the peritoneum as an ideal destination. During surgery, placing the distal end of the catheter at the cavo-atrial junction is essential for preventing possible complications.  Objective:  To describe the clinical characteristics in a patient who received fluoroscopy-guided ventriculo-atrial shunt.  Case presentation:  Female, 26 years old, right handedness with antecedents of post-meningitic communicating hydrocephalus in childhood, for which she was submitted to ventriculo-peritoneal shunt. She underwent multiple reinterventions due to catheter obstruction. She started with intracranial hypertension signs, so the catheter was exteriorized, with symptoms disappearing. It is replaced in the transcavity of the omentum and presents reappearance of neurological symptoms, peritoneal syndrome and pseudocysts on abdominal ultrasound. The decision was made to perform a ventriculo-atrial shunt with the fluoroscopic method in order to guarantee ideal position. She has been maintained with antiplatelet treatment and echocardiographic and radiological monitoring, without complications.  Conclusions:  Ventriculo-atrial shunt is an option when ventriculo-peritoneal shunt is contraindicated. The use of transoperative fluoroscopy allows optimal placing of catheter distal end. Serial echocardiography allows early detection of potential complications and antiplatelet therapy contributes to reducing those of intravascular origin.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Derivación ventrículo-atrial]]></kwd>
<kwd lng="es"><![CDATA[hidrocefalia]]></kwd>
<kwd lng="es"><![CDATA[derivación ventriculoperitoneal]]></kwd>
<kwd lng="es"><![CDATA[complicaciones]]></kwd>
<kwd lng="es"><![CDATA[fluoroscopia]]></kwd>
<kwd lng="en"><![CDATA[Ventriculo-atrial shunt]]></kwd>
<kwd lng="en"><![CDATA[hydrocephalus]]></kwd>
<kwd lng="en"><![CDATA[ventriculo-peritoneal shunt]]></kwd>
<kwd lng="en"><![CDATA[complications]]></kwd>
<kwd lng="en"><![CDATA[fluoroscopy]]></kwd>
</kwd-group>
</article-meta>
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