Key result
Angiocardiography was the most useful diagnostic procedure for assessing cardiovascular union in 5 cases of thoracoomphalopagus conjoined twins, revealing varying degrees of connection.
Case Report (n=5)
Angiocardiography is the most useful diagnostic procedure for assessing the extent of cardiovascular union in thoracopagus conjoined twins.
May inform separation planning in rare thoracopagus cases; leaves open validation against contemporary noninvasive imaging.
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.
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Terro Izukawa (1978) conducted a case report in Thoracoomphalopagus conjoined twins (n=5). Cardiovascular assessment (angiocardiography and ECG) was evaluated on Cardiovascular anatomy and degree of union. Angiocardiography was the most useful diagnostic procedure for assessing cardiovascular union in 5 cases of thoracoomphalopagus conjoined twins, revealing varying degrees of connection.
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