Anaesthetic management of thoracopagus twins with complex cyanotic heart disease for cardiac assessment: special considerations related to ventilation and cross-circulation.
نویسندگان
چکیده
We describe the anaesthetic management of a pair of thoracopagus twins of 14 months of age undergoing complex cardiac evaluation. Synchronous ventilation of the twins, needed for the ECG-gated magnetic resonance imaging-angiography, was achieved through a Carlens (Y) adaptor during procedures and transport. The complex logistical implications are obvious. We also describe the first use of bispectral index monitor for detection of cross-circulation in conjoint twins.
منابع مشابه
Anaesthetic managements for conjoined twins with complex cardiac anomalies.
PURPOSE To describe the perioperative assessment and anaesthetic management for surgical separation of three sets of conjoined twins with complex cardiac anomalies threatened with arterial desaturation and haemodynamic instability. CLINICAL FEATURES Three sets of conjoined twins, one omphaloischiopagus, one omphalopagus, and one thoraco-omphalopagus, were considered for separation during the ...
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Thoracopagus is the most common form of conjoined twins. Cardiovascular evaluation is necessary to establish the existence of 2 separate hearts before planning surgical separation of the twins. This is usually done by cardiac ultrasound, cardiac catheterization, documenting 2 separate pulse rates on physical examination, and the presence of 2 independent QRS complexes on simultaneously recorded...
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Although thoracopagus twins joined at the upper chest are the most common type of conjoined twins, the separation surgery in these cases has a higher mortality rate. Here, we describe an anesthetic management approach for the separation of thoracopagus conjoined twins sharing parts of a congenitally defective heart and liver. We emphasize the importance of vigilant intraoperative hemodynamic mo...
متن کاملThoracopagus conjoined twins.
The incidence of conjoined twins is estimated at 1 in 50 000 births.1 Thoracopagus is the most common form of conjoined twins,2 with fusion from the anterior thorax to the umbilicus. A common pericardial sac is present in 90% of thoracopagus twins, and conjoined hearts are seen in 75%.3 The present case was diagnosed prenatally, and the twins subsequently experienced intrauterine demise at 22 w...
متن کاملCardiovascular anomalies in thoracopagus twins and the importance of preoperative cardiac evaluation.
Four pairs of thoracopagus twins have been described. Cardiac catheterisation was performed in all the cases. Angiocardiographic and necropsy findings suggest that the most common abnormality was some form of univentricular heart. The communication between the 2 hearts was at atrial level in 2 cases. Separation was performed in 1 of these cases but only 1 of the twins survived for 14 hours afte...
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ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 96 3 شماره
صفحات -
تاریخ انتشار 2006