title: Anaesthetic management of the surgical separation of a pair of thoracopagus-cardiopagus twins.
abstract: We describe the anaesthetic management of the surgical separation of a pair of thoracopagus-cardiopagus twins with a common right atrium and a myocardial tissue bridge containing vascular channels between their ventricles. One of them died during the procedure, the surviving twin is now two years old. The survival of one twin for two years without significant sequelae, after the surgical separation of twins with shared right atrium and fused ventricles, has not previously been reported. Careful preoperative assessment is essential to anticipate potential serious problems during the procedure.
authors.affiliation: Department of Paediatric Anaesthesia, Virgen del Rocío's Children's Hospital, Seville, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Suan
authors.forename: R
authors.initials: R
authors.lastname: Ojeda
authors.forename: J L
authors.initials: JL
authors.lastname: García-Perla
authors.forename: J
authors.initials: J
authors.lastname: Cerro
authors.forename: D
authors.initials: D
authors.lastname: Romero
authors.forename: J
authors.initials: J
authors.lastname: Gilabert
authors.forename: A
authors.initials: A
authors.lastname: González
authors.forename: G
authors.initials: G
authors.lastname: Casas
authors.forename: L
authors.initials: L
authors.lastname: Sánchez-Felipe
authors.forename: F
authors.initials: F
authors.lastname: Peñasco
authors.forename: J
authors.initials: J
authors.lastname: Repullo
mesh_terms: D000768:Anesthesia, General; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D017809:Fatal Outcome; D005283:Fentanyl / Q000008:administration & dosage; D005500:Follow-Up Studies; D006325:Heart Atria / Q000002:abnormalities / Q000601:surgery; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007530:Isoflurane / Q000008:administration & dosage; D007649:Ketamine / Q000008:administration & dosage; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D010197:Pancuronium / Q000008:administration & dosage; D010347:Patient Care Planning; D013909:Thorax / Q000002:abnormalities*; D014428:Twins, Conjoined / Q000601:surgery*
chemical_list: D000778:Anesthetics, Dissociative; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D007649:Ketamine; D007530:Isoflurane; D010197:Pancuronium; D005283:Fentanyl