title: Anaesthetic management of thoracopagus twins with complex cyanotic heart disease for cardiac assessment: special considerations related to ventilation and cross-circulation.
abstract: 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.
authors.affiliation: Department of Anesthesiology, University of Texas Medical School at Houston, TX 77030, USA. pszmuk@gmail.com
authors.forename: P
authors.initials: P
authors.lastname: Szmuk
authors.forename: M F
authors.initials: MF
authors.lastname: Rabb
authors.forename: B
authors.initials: B
authors.lastname: Curry
authors.forename: K J
authors.initials: KJ
authors.lastname: Smith
authors.forename: M R
authors.initials: MR
authors.lastname: Lantin-Hermoso
authors.forename: T
authors.initials: T
authors.lastname: Ezri
mesh_terms: 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*