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BJA Advance Access originally published online on January 16, 2006
British Journal of Anaesthesia 2006 96(3):341-345; doi:10.1093/bja/aei313
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

CASE REPORT

Anaesthetic management of thoracopagus twins with complex cyanotic heart disease for cardiac assessment: special considerations related to ventilation and cross-circulation

P. Szmuk1,3,*, M. F. Rabb1, B. Curry1, K. J. Smith1, M. R. Lantin-Hermoso2 and T. Ezri3,4

1 Department of Anesthesiology and 2 Department of Pediatrics, Division of Cardiology, University of Texas Medical School at Houston, TX, USA. 3 Outcomes ResearchTM Institute, Louisville, KY, USA. 4 Department of Anesthesia, Wolfson Medical Center, Holon, Affiliated to Sackler School of Medicine, Tel Aviv University, Israel

* Corresponding author: 6431 Fannin, MSB 5020, Houston, TX 77030, USA. E-mail: pszmuk{at}gmail.com

We describe the anaesthetic management of a pair of thoracopagus twins of 14 months of age undergoing complex cardiac evaluation. Synchronous ventilation of the twins, needed for the ECG-gated magnetic resonance imaging-angiography, was achieved through a Carlens (Y) adaptor during procedures and transport. The complex logistical implications are obvious. We also describe the first use of bispectral index monitor for detection of cross-circulation in conjoint twins.


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