title: The management of conjoined twins: Cardiology assessment.
abstract: Structural cardiac defects occur in at least 1 twin in about 75% of conjoined twins with thoracic level fusion. Outcomes after surgical separation of thoracic level conjoined twins have been favorable when the hearts have been separate. However, even in this situation, the outlook is poor for an individual twin with an important cardiac defect. Arterial anastomosis between twin circulations is an important additional consideration, with poor outcomes for perfusion recipient twins. Surgical separation is contraindicated when ventricular level cardiac fusion exists. Cardiac assessment is a key component of prenatal counseling.
authors.affiliation: Cardiothoracic Unit, Great Ormond Street Hospital, London WC1N 3JH, UK.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Andrews
authors.affiliation: Cardiothoracic Unit, Great Ormond Street Hospital, London WC1N 3JH, UK.
authors.forename: Robert W M
authors.initials: RW
authors.lastname: Yates
authors.affiliation: Cardiothoracic Unit, Great Ormond Street Hospital, London WC1N 3JH, UK. Electronic address: ian.sullivan@gosh.nhs.uk.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Sullivan
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D011296:Prenatal Diagnosis / Q000379:methods*; D013909:Thorax / Q000002:abnormalities*; D014428:Twins, Conjoined / Q000196:embryology / Q000473:pathology* / Q000601:surgery*
keywords: Cardiac defects; Conjoined twins; Echocardiography; Prenatal diagnosis