Anaesthetic managements for conjoined twins with complex cardiac anomalies

Chen, Ta-Liang; Lin, Chu‐Chuan; Lai, Hung-Wen; Chen, W. J.; Chao, Che‐Yi; Liu, C. C.

doi:10.1007/bf03011846

Cited by 7 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Khan described an ischiopagus tripus in which the healthier-looking active pink neonate showed a gradual infra-umbilical broadening of the torso towards a smaller neonate that was thin, emaciated, cyanotic, microcephalic, with a small torso and feeble reflexes. Again, this case could be interpreted as being a highly developed parasite [55]. An ileoischiopagus twin from the Vrolik collection in Amsterdam with facial dysmorphic features and hygroma colli indicating a possible association with Down syndrome was described by Oostra et al (1998).…”

Section: Discordance In Caudally United Twinsmentioning

confidence: 84%

Phenotypically Discordant Anomalies in Conjoined Twins: Quirks of Nature Governed by Molecular Pathways?

Boer,

Winter,

Gorissen

et al. 2023

Diagnostics

View full text Add to dashboard Cite

A multitude of additional anomalies can be observed in virtually all types of symmetrical conjoined twins. These concomitant defects can be divided into different dysmorphological patterns. Some of these patterns reveal their etiological origin through their topographical location. The so-called shared anomalies are traceable to embryological adjustments and directly linked to the conjoined-twinning mechanism itself, inherently located within the boundaries of the coalescence area. In contrast, discordant patterns are anomalies present in only one of the twin members, intrinsically distant from the area of union. These dysmorphological entities are much more difficult to place in a developmental perspective, as it is presumed that conjoined twins share identical intra-uterine environments and intra-embryonic molecular and genetic footprints. However, their existence testifies that certain developmental fields and their respective developmental pathways take different routes in members of conjoined twins. This observation remains a poorly understood phenomenon. This article describes 69 cases of external discordant patterns within different types of otherwise symmetrical mono-umbilical conjoined twins and places them in a developmental perspective and a molecular framework. Gaining insights into the phenotypes and underlying (biochemical) mechanisms could potentially pave the way and generate novel etiological visions in the formation of conjoined twins itself.

show abstract

Section: Discordance In Caudally United Twinsmentioning

confidence: 84%

Phenotypically Discordant Anomalies in Conjoined Twins: Quirks of Nature Governed by Molecular Pathways?

Boer,

Winter,

Gorissen

et al. 2023

Diagnostics

View full text Add to dashboard Cite

show abstract

“…The rotation of children's heads from the lateral position to close to the sagittal one in order to facilitate intubation may in turn deform the upper airway [21,[26][27][28][29]. Some authors are of opinion that prolonged conjoined twinning may lead to the development of severe cervical lordosis and inhibition of mandible growth, which additionally increases the difficulties in intubation [30][31][32]. After intubation, it is essential to fix the endotracheal tube.…”

mentioning

confidence: 99%

“…Therefore, some authors prefer to perform these surgeries on days off, not to disturb normal functioning of the operating suite and to avoid many observers at the operating theatre [21,[29][30][31]. It is also recommended to carry rehearsals at the operating theatre, which allow determining the exact role of each specialist involved in separation surgery [2,34].…”

mentioning

confidence: 99%

Znieczulenie bliźniąt syjamskich

Kobylarz

2014

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

Conjoined twins have been a source of fascination to the public and the medical profession for centuries. Their birth was initially viewed as an ominous sign of impending disaster. Since Middle Ages into the 19 th century they were regarded as monstrosities and were exhibited at circuses and sideshows. The frequency of conjoined twins is approximately 1 in 50,000 gestation, but many of them die in utero, are terminated or stillborn. The true incidence is estimated to be 1 in 200,000 live births. This article gives an overview of Siamese twins and of the prenatal diagnosis in assessing the prognosis, anaesthetic and post-natal surgical management and outcome. Anaesthesia for conjoined twins surgery, whether prior to or for separation, is an enormous challenge to the anaesthesiologist. The site and complexity of the conjunction affect management of the airway, an intravenous access, the extent of blood and number of surgical specialties involved. Preoperative assessment and planning with interdisciplinary communication and cooperation is vital to the success of the operations. Meticulous attention to detail, monitoring and vigilance are mandatory.

show abstract

Anesthesia-related medication error: time to take action

Orser

Byrick

2004

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Anaesthetic managements for conjoined twins with complex cardiac anomalies

Cited by 7 publications

References 16 publications

Phenotypically Discordant Anomalies in Conjoined Twins: Quirks of Nature Governed by Molecular Pathways?

Phenotypically Discordant Anomalies in Conjoined Twins: Quirks of Nature Governed by Molecular Pathways?

Znieczulenie bliźniąt syjamskich

Anesthesia-related medication error: time to take action

Contact Info

Product

Resources

About