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Conjoined Hearts in Thoracopagus Twins

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Abstract

This study aimed to identify the anatomic and pathologic structural cardiac abnormalities in conjoined twins and to focus on those that have prevented the successful separation of conjoined hearts. A retrospective review was undertaken to examine consecutive cases of thoracopagus conjoined twins with conjoined hearts evaluated at The Children’s Hospital of Philadelphia from 1 January 1980 through 6 October 2008. The records included autopsy and surgical findings as well as clinical reports. The study group included nine sets of conjoined twins with a mean gestational age at birth of 33.8 ± 5.5 weeks. Three twin pairs were stillborn. Five twin pairs died afterward. One pair died of cardiopulmonary failure. The median age at death was 22 days (range, 0–345 days). Major congenital heart disease was present in 94.4% (17/18) of the hearts, and 72.2% (13/18) of the hearts had single-ventricle physiology. Total anomalous pulmonary venous return occurred in 39% (7/18) of the cases. The clinical outcome for thoracopagus twins with conjoined hearts remains poor because of inability to separate conjoined and single ventricles. Surgical nonintervention and palliative care should be strongly considered for these patients.

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Acknowledgments

The authors thank Alvin J. Chin, MD, for his insight in the preparation of this article.

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Authors and Affiliations

  1. Division of Cardiology, Arkansas Children’s Hospital, 1 Children’s Way, Mail Slot 512-3, Little Rock, AR, 72202, USA

    R. Thomas Collins II

  2. Department of Pediatrics, The University of Arkansas for Medical Sciences, Little Rock, AR, USA

    R. Thomas Collins II

  3. Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Paul M. Weinberg

  4. Division of Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Peter J. Gruber

  5. Department of Pathology and Laboratory Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Paul M. Weinberg

  6. Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Paul M. Weinberg

  7. Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Martin G. St. John Sutton

  8. University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Paul M. Weinberg, Peter J. Gruber & Martin G. St. John Sutton

Authors
  1. R. Thomas Collins II
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  2. Paul M. Weinberg
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  4. Martin G. St. John Sutton
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Correspondence to R. Thomas Collins II.

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Thomas Collins, R., Weinberg, P.M., Gruber, P.J. et al. Conjoined Hearts in Thoracopagus Twins. Pediatr Cardiol 33, 252–257 (2012). https://doi.org/10.1007/s00246-011-0125-3

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  • DOI: https://doi.org/10.1007/s00246-011-0125-3

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