A 65-year-old woman was referred to our cardiology unit because of tamponade due to important pericardial effusion, which was surgically evacuated. Neither virus serology nor pericardial biopsy found a specific aetiology. The pericardial effusion recurred a few weeks after surgery. In her medical history we noticed the implantation of a ventriculoatrial shunt 15 years earlier, before surgical ablation of a compressive benign pinealocytoma. A computed tomography scan of the chest showed a right atrial perforation by the distal part of the ventriculoatrial catheter ( Fig. 1 , arrows). After the ventriculoatrial shunt was replaced by a ventriculoperitoneal shunt, the distal portion of the protruding catheter was surgically removed and the atrial wall perforation repaired ( Fig. 2 , arrows). The patient made a full recovery without recurrence of the pericardial effusion. The possibility of such a late complication of a ventriculoatrial shunt deserves to be known and could give preference to a ventriculoperitoneal shunt.
