Assessment of the cardiovascular system in conjoined thoracopagus twins
T. Izukawa, B. S. Kidd, C. A. Moes, M. J. Tyrrell, E. J. Ives, J. S. Simpson and B. Shandling
The thoracoomphalopagus conjoined twins comprise 75% of all conjoined
twins. In the assessment of the organ systems of the twins, the
cardiovascular system is important since union of this system in the twins
has occurred in 75% of the cases. Of the five cases reported here, two had
separate hearts and vessels with a common pericardium only. Two twins were
joined at the right atrial level. The fifth pair were connected at both
atrial and ventricular levels. It has been suggested that the presence of
two separate QRS complexes in the ECG indicates complete separation of the
two hearts. Case 4 shows that even in the presence of atrial union, the
existence of an atrioventricular block in one twin may produce a very slow
heart rate, while the other twin may have a normal rate that will not
influence the ventricular rate of the other. In our experience,
angiocardiography has been the most useful diagnostic procedure.
