Anaesthetic management of thoracopagus twins with complex cyanotic heart disease for cardiac assessment: special considerations related to ventilation and cross-circulation.
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.
Szmuk
P
P
Department of Anesthesiology, University of Texas Medical School at Houston, TX 77030, USA. pszmuk@gmail.com
Rabb
M F
MF
Curry
B
B
Smith
K J
KJ
Lantin-Hermoso
M R
MR
Ezri
T
T
D000768:Anesthesia, General / Q000379:methods*; D003326:Coronary Circulation; D003427:Cross Circulation; D004200:Diseases in Twins / Q000175:diagnosis*; D004562:Electrocardiography; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D014428:Twins, Conjoined / Q000503:physiopathology*