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

Abstract

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. © The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved.