Pediatric Cardiology

, Volume 33, Issue 1, pp 192–200 | Cite as

Various Modalities for Evaluation of a Fused Heart in Conjoined Twins

  • Hao-Chuan Liu
  • Chiao-Wei Lo
  • Zen-Chung Weng
  • Betau Hwang
  • Pi-Chang Lee
Case Report


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.


Anatomy Computed tomography Fused-heart conjoined twins Imaging Thoracopagus 



The authors sincerely thank Dr. Ying-Ju Kuo for providing the anatomic pathology pictures. We also thank Dr. Shu-Jen Chen for the conjoined twins’ neonatal intensive care consultation.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Hao-Chuan Liu
    • 1
  • Chiao-Wei Lo
    • 2
  • Zen-Chung Weng
    • 4
  • Betau Hwang
    • 5
  • Pi-Chang Lee
    • 3
  1. 1.Department of PediatricsTaipei Veterans General Hospital Yuanshan BranchTaiwanRepublic of China
  2. 2.Department of PediatricsNational Yang-Ming University HospitalTaipei, TaiwanRepublic of China
  3. 3.Division of Pediatric Cardiology, Department of PediatricsTaipei Veterans General Hospital and National Yang-Ming UniversityTaipei, TaiwanRepublic of China
  4. 4.Department of SurgeryTaipei Veterans General Hospital and National Yang-Ming UniversityTaipei, TaiwanRepublic of China
  5. 5.Taipei City Hospital Zhongxiao BranchTaipei, TaiwanRepublic of China

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