Author + information
- Received July 11, 1983
- Revision received November 7, 1983
- Accepted November 11, 1983
- Published online April 1, 1984.
- James W. Mathewson, MD, FACCa,
- Jon D. Waldman, MD, FACC,
- Lily George, MD,
- Stanley E. Kirkpatrick, MD, FACC,
- Searle W. Turner, MD, FACC and
- Stanley J. Pappelbaum, MD, FACC
- ↵aAddress for reprints: James W. Mathewson, MD, Divison of Cardiology, Children's Hospital of San Diego, 8001 Frost Street, San Diego. California 92123.
A pair of type B thoracopagus twins with complex cyanotic heart disease had shared coronary arteries and coronary venous drainage. Surgical separation was not attempted and the twins died at 10.5 months of age. Antemortem angiography demonstrated that Twin A's right coronary artery supplied Twin B's diaphragmatic and anterior ventricular myocardial free wall. A midline communication existed between each twin's right atrium at a common coronary sinus. The crossing coronary artery coursed alongside this connection and was visualized echocardiographically. At postmortem examination, the great cardiac vein of Twin A drained into the orifice of the common coronary sinus on Twin B's side of the midline.
In five of six previously reported cases, the children died at attempted separation shortly after ligation of the interatrial communication. This may have been because of occlusion of a coronary artery or acute obstruction of a coronary vein. Consideration of separation of type B thoracopagus twins requires anatomic delineation of the coronary arteries and veins.
- Received July 11, 1983.
- Revision received November 7, 1983.
- Accepted November 11, 1983.
- American College of Cardiology Foundation