Korean J Anesthesiol.
2015 Jun;68(3):295-299. 10.4097/kjae.2015.68.3.295.
Anesthetic management for separation of thoracopagus twins with complex congenital heart disease: a case report
- Affiliations
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- 1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. wjshin@amc.seoul.kr
- 2Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- KMID: 2148697
- DOI: http://doi.org/10.4097/kjae.2015.68.3.295
Abstract
- Although thoracopagus twins joined at the upper chest are the most common type of conjoined twins, the separation surgery in these cases has a higher mortality rate. Here, we describe an anesthetic management approach for the separation of thoracopagus conjoined twins sharing parts of a congenitally defective heart and liver. We emphasize the importance of vigilant intraoperative hemodynamic monitoring for early detection of unexpected events. Specifically, real-time continuous monitoring of cerebral oximetry using near-infrared spectroscopy allowed us to promptly detect cardiac arrest and hemodynamic deterioration.
