Transcatheter balloon atrial septostomy in thoraco-omphalopagus conjoined twins

摘要

Conjoined twinning is a rare congenital anomaly with a reported incidence of 1 in 50,000-200,000 births [ , ]. Fusion at the thoracic level (thoracopagus) is the most common variety (40% of cases) followed by the abdomen (omphalopagus, 32%) [ ]. Cardiac anomalies are common in these patients and range from shared pericardium to fused atria and ventricles [ ]. Congenital heart disease (CHD) is common in addition to cardiac fusion in these children [ ]. Perinatal outcomes are determined by the severity of cardiac involvement. Overall survival for conjoined twins is dismal at 25% [ ]. Survival after successful separation for a conjoined twin with fused hearts is even more rare, with reported survival of 10% if fused at the atrial level and 0% if fused at the ventricular level [ , ].