Pediatric Cardiology

, Volume 33, Issue 1, pp 192–200

Various Modalities for Evaluation of a Fused Heart in Conjoined Twins

Authors

  • Hao-Chuan Liu
    • Department of PediatricsTaipei Veterans General Hospital Yuanshan Branch
  • Chiao-Wei Lo
    • Department of PediatricsNational Yang-Ming University Hospital
  • Zen-Chung Weng
    • Department of SurgeryTaipei Veterans General Hospital and National Yang-Ming University
  • Betau Hwang
    • Taipei City Hospital Zhongxiao Branch
    • Division of Pediatric Cardiology, Department of PediatricsTaipei Veterans General Hospital and National Yang-Ming University
Case Report

DOI: 10.1007/s00246-011-0117-3

Cite this article as:
Liu, H., Lo, C., Weng, Z. et al. Pediatr Cardiol (2012) 33: 192. doi:10.1007/s00246-011-0117-3

Abstract

Conjoined twins are a rare congenital anomaly with an estimated incidence of 1/50,000 to 1/100,000. Among thoracopagus conjoined twins, 75% have a fused heart. We compare the usefulness of various modalities for evaluating cardiovascular structure in fused-heart conjoined twins. We report a series of 20 sets of thoracopagus conjoined twins as well as the results of a PubMed database literature review literature from 1982 to 2009. Twenty sets of fused-heart thoracopagus conjoined twins were evaluated by echocardiography, cardiac catheterization, magnetic resonance image (MRI), and three-dimensional computed tomography angiography (3D-CTA). Imaging results were compared to findings at surgery or autopsy. All sets of conjoined twins underwent postnatal echocardiography; 11 sets (55%) underwent cardiac catheterization; 4 sets (20%) underwent MRI; and 1 set (5%) underwent 3D-CTA. All intracardiac anatomy (ICA) was identified by echocardiography. Cardiac catheterization, MRI, and 3D-CTA were able to identify extracardiac vascular structures as well as the ICA. 3D-CTA, which can be performed as early as the first week of life, is a noninvasive, less expensive, and the safe examination with minimal risk due to its short procedural time. Three-dimensional CTA is an effective and safe modality for evaluating the cardiovascular anatomy of fused-heart conjoined twins before surgery.

Keywords

AnatomyComputed tomographyFused-heart conjoined twinsImagingThoracopagus

Copyright information

© Springer Science+Business Media, LLC 2011