The management of conjoined twins: Cardiology assessment.

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.

[1]  A. Liao,et al.  Twenty-five years of fetal echocardiography in conjoined twins: lessons learned. , 2013, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[2]  P. Weinberg,et al.  Conjoined Hearts in Thoracopagus Twins , 2012, Pediatric Cardiology.

[3]  A. Pierini,et al.  Conjoined twins: A worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research , 2011, American journal of medical genetics. Part C, Seminars in medical genetics.

[4]  A. Moon‐Grady,et al.  Monochorionic twins discordant for congenital heart disease: a referral center's experience and possible pathophysiologic mechanisms , 2011, Prenatal diagnosis.

[5]  J. Copel,et al.  Congenital heart defects in twin gestations. , 2009, Minerva ginecologica.

[6]  N. Manning.  The influence of twinning on cardiac development. , 2008, Early human development.

[7]  T. Hara,et al.  Monochorionic twins in which at least one fetus has a congenital heart disease with or without twin-twin transfusion syndrome , 2007, Journal of perinatal medicine.

[8]  N. Archer,et al.  A study to determine the incidence of structural congenital heart disease in monochorionic twins , 2006, Prenatal diagnosis.

[9]  L. Spitz,et al.  Echocardiographic assessment of conjoined twins , 2005, Heart.

[10]  C. McMahon,et al.  Congenital Heart Defects in Conjoined Twins: Outcome After Surgical Separation of Thoracopagus , 2006, Pediatric Cardiology.

[11]  A. Cook,et al.  Early fetal diagnosis of monochorionic twins concordant for hypoplastic left heart syndrome , 2004, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.