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J Thorac Cardiovasc Surg 2005;130:1212-1213
© 2005 The American Association for Thoracic Surgery

Brief Communication

Separation of thoracopagus-cardiopagus twins joined by a myocardial bridge

Louis C. Benjamin, MD a , * , Jai Nahar, MD b , Craig Sable, MD b , Frank M. Midgley, MD c , Gregory B. Di Russo, MD c

a Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
b Division of Cardiology, Children's National Medical Center, Washington, DC.
c Department of Pediatric Cardiac Surgery, Children's National Medical Center, Washington, DC.

Received for publication April 13, 2005; accepted for publication April 21, 2005.

* Address for reprints: Louis C. Benjamin, MD, Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213. (Email: lcbenjamin03@comcast.net).

The first 20% of the full text of this article appears below.


Figure 1
Dr Benjamin


Thorcopagus twins often have complex cardiac anomalies associated with other congenital defects. 1 Go This has precluded successful separation in the past.

We report a case in which a very small connecting bridge of myocardial tissue resulted in one ventricle pacing the other in thoracopagus-cardiopagus twins. This defect was not noted before the operation, despite extensive imaging. Surgical division and subsequent independent QRS complexes seen after separation of the myocardial bridge as in our case has not previously been reported.

Clinical Summary

Four-month-old infants born as conjoined twins were delivered at 34 weeks' gestational age by cesarean section. They were known to have a shared liver and were connected at the abdominal and thoracic cavities.

Cardiac evaluation included electrocardiography, echocardiography, cardiac catheterization, magnetic resonance imaging, . . . [Full Text of this Article]






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