A Century With Craniopagus Twin Separation Surgeries: Nihilism to Optimism. Issue 1 (6th July 2022)
- Record Type:
- Journal Article
- Title:
- A Century With Craniopagus Twin Separation Surgeries: Nihilism to Optimism. Issue 1 (6th July 2022)
- Main Title:
- A Century With Craniopagus Twin Separation Surgeries: Nihilism to Optimism
- Authors:
- Gupta, Deepak
Kedia, Shweta
Rath, Girija Prasad
Pandia, Mihir Prakash
Chauhan, Sandeep
Sharma, Rajeev
Raheja, Amol
Darbari, Shaurya
Kamra, Devasheesh
Malik, Vishwas
Saxena, Anita
Hote, Milind
Lodha, Rakesh
Gulati, Sheffali
Jauhari, Prashant
Sankar, Jhuma
Sinha, Aditi
Bagga, Arvind
Kapil, Arti
Singhal, Maneesh
Chauhan, Shashank
Tiwari, Raja
Prabhakar, Anuj
Gaikwad, Shailesh B.
Takizawa, Katsumi
Sabapathy, S. Raja
Mazzeo, Anna Teresa
Jaryal, Ashok
Kale, Shashank Sharad
Mahapatra, Ashok Kumar - Abstract:
- Abstract : Craniopagus conjoined twins are extremely rare, reported 1 in 2.5 million live births. To date, 62 separation attempts in 69 well-documented cases of craniopagus twins have been made. Of these, 34 were performed in a single-stage approach, and 28 were attempted in a multistage approach. One or both twins died of massive intraoperative blood loss and cardiac arrest in 14 cases. We report our surgical experience with conjoined craniopagus twins (JB) with type III total vertical joining and shared circumferential/circular sinus with left-sided dominance. A brief review of the literature is also provided. In our twins, the meticulous preoperative study and planning by the multidisciplinary team consisting of 125-member, first-staged surgical separation consisted of creation of venous conduit to bypass part of shared circumferential sinus and partial hemispheric disconnection. Six weeks later, twin J manifested acute cardiac overload because of one-way fistula development from blocked venous bypass graft necessitating emergency final separation surgery. Unique perioperative issues were abnormal anatomy, hemodynamic sequelae from one-way fistula development after venous bypass graft thrombosis, cardiac arrest after massive venous air embolism requiring prolonged cardiopulmonary resuscitation, and return of spontaneous circulation at 15 minutes immediately after separation. This is the first Indian craniopagus separation surgery in a complex total vertical craniopagusAbstract : Craniopagus conjoined twins are extremely rare, reported 1 in 2.5 million live births. To date, 62 separation attempts in 69 well-documented cases of craniopagus twins have been made. Of these, 34 were performed in a single-stage approach, and 28 were attempted in a multistage approach. One or both twins died of massive intraoperative blood loss and cardiac arrest in 14 cases. We report our surgical experience with conjoined craniopagus twins (JB) with type III total vertical joining and shared circumferential/circular sinus with left-sided dominance. A brief review of the literature is also provided. In our twins, the meticulous preoperative study and planning by the multidisciplinary team consisting of 125-member, first-staged surgical separation consisted of creation of venous conduit to bypass part of shared circumferential sinus and partial hemispheric disconnection. Six weeks later, twin J manifested acute cardiac overload because of one-way fistula development from blocked venous bypass graft necessitating emergency final separation surgery. Unique perioperative issues were abnormal anatomy, hemodynamic sequelae from one-way fistula development after venous bypass graft thrombosis, cardiac arrest after massive venous air embolism requiring prolonged cardiopulmonary resuscitation, and return of spontaneous circulation at 15 minutes immediately after separation. This is the first Indian craniopagus separation surgery in a complex total vertical craniopagus twin reported by a single-center multidisciplinary team. Both twins could be sent home, but one remained severely handicapped. Adequate perioperative planning and multidisciplinary team approach are vital in craniopagus twin separation surgeries. … (more)
- Is Part Of:
- Neurosurgery. Volume 91:Issue 1(2022)
- Journal:
- Neurosurgery
- Issue:
- Volume 91:Issue 1(2022)
- Issue Display:
- Volume 91, Issue 1 (2022)
- Year:
- 2022
- Volume:
- 91
- Issue:
- 1
- Issue Sort Value:
- 2022-0091-0001-0000
- Page Start:
- 27
- Page End:
- 42
- Publication Date:
- 2022-07-06
- Subjects:
- Craniopagus conjoined twins -- Circular sinus -- Venous bypass -- ROSC -- Return of spontaneous circulation
Nervous system -- Surgery -- Periodicals
617.48005 - Journal URLs:
- https://academic.oup.com/neurosurgery ↗
http://www.neurosurgery-online.com ↗
https://journals.lww.com/neurosurgery/pages/default.aspx ↗
http://journals.lww.com ↗ - DOI:
- 10.1227/neu.0000000000001962 ↗
- Languages:
- English
- ISSNs:
- 0148-396X
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 6081.582000
British Library DSC - BLDSS-3PM
British Library STI - ELD Digital store - Ingest File:
- 26786.xml