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(Circulation. 1999;100:103.)
© 1999 American Heart Association, Inc.
Images in Cardiovascular Medicine |
Cardiovascular Evaluation in Thoracopagus Twins
From Harvard Medical School, Children's Hospital, Boston, Mass.
Correspondence to Alfonso Casta, MD, Cardiac Anesthesia Service, Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115.
Thoracopagus is the most common form of conjoined twins.
Cardiovascular evaluation is necessary to establish the
existence of 2 separate hearts before planning surgical separation of
the twins. This is usually done by cardiac ultrasound, cardiac
catheterization, documenting 2 separate pulse rates on
physical examination, and the presence of 2 independent QRS complexes
on simultaneously recorded ECGs. A set of thoracopagus
twins underwent cardiac catheterization to confirm the
presence of severe congenital heart defect in 1 of the twins before
surgical separation. The other twin had no congenital heart defect. ECG
electrodes were placed in the chest of the twins, and the
recording is shown in the Figure
.
Two independent QRS complexes were recorded in ECG lead III. One
QRS complex (small arrow) appears to be marching through the other
complex (larger arrow). Heart rates are similar.
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Footnotes
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
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