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Anesth Analg. 2005 Jul;101(1):44-7, table of contents.

Anesthetic management of conjoined twins presenting for palliative open-heart surgery.

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  • 1Division of Cardiovascular Anesthesia, Congenital Heart Institute of Miami Children's Hospital and Arnold Palmer Hospital for Children & Women, Florida 33155, USA.


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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