Epanchementpericardique ;Tomodensitometrie ;Chirurgie cardiaqueA 65-year-old woman was referred to our cardiology unit because of tamponade due toimportant pericardial effusion, which was surgically evacuated. Neither virus serology norpericardial biopsy found a specific aetiology. The pericardial effusion recurred a few weeksafter surgery. In her medical history we noticed the implantation of a ventriculoatrialshunt 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 distalpart of the ventriculoatrial catheter (Fig. 1, arrows). After the ventriculoatrial shunt wasreplaced by a ventriculoperitoneal shunt, the distal portion of the protruding catheter wassurgically removed and the atrial wall perforation repaired (Fig. 2, arrows). The patientmade a full recovery without recurrence of the pericardial effusion. The possibility ofsuch a late complication of a ventriculoatrial shunt deserves to be known and could givepreference to a ventriculoperitoneal shunt.