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Anesth Analg 2005;101:44-47
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000153504.05295.15

PEDIATRIC ANESTHESIA

Anesthetic Management of Conjoined Twins Presenting for Palliative Open-Heart Surgery

Christopher F. Tirotta, MD, MBA, Richard Lagueruela, MD, Hamish M. Munro, MD, FRCA, Evan M. Zahn, MD, Leo Lopez, MD, and Redmond P. Burke, MD

Division of Cardiovascular Anesthesia, Congenital Heart Institute of Miami Children’s Hospital and Arnold Palmer Hospital for Children & Women, Miami, Florida

A set of dicephalous parapagus twins was born at 36 wk gestational age. Twin A had complex congenital heart disease in the form of a single ventricle that would be fatal without surgical intervention. Twin B had normal intracardiac anatomy. The twins were deemed surgically inseparable and the parents requested palliative open-heart surgery on Twin A. The twins shared a common circulatory system to the lower half of the body so that physiological manipulations in one twin adversely affected the other’s hemodynamic condition. Twin A underwent successful single ventricle palliation; however, after a prolonged hospitalization, the infants died secondary to severe respiratory disease in Twin B.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.