Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest

D. E. Cameron, B. A. Reitz, Benjamin Solomon, D. M. Long, C. R. Dufresne, Craig Vander Kolk, L. G. Maxwell, D. M. Tilghman, D. G. Nichols, R. C. Wetzel, M. C. Rogers, C. Walton Lillehei, Castaneda

Research output: Contribution to journalArticle

Abstract

Occipitally joined craniopagus Siamese twins were separated with the use of cardiopulmonary bypass and hypothermic circulatory arrest. The 7-month-old infants shared a large sagittal venous sinus that precluded conventional neurosurgical approach because of risk of exsanguination and air embolism. After craniotomy and preliminary exposure of the sinus, each twin underwent sternotomy and total cardiopulmonary bypass with deep hypothermia. Hypothermic circulatory arrest allowed safe division and subsequent reconstruction of the sinus remnants. Several unusual problems were encountered, including transfusion of a large blood volume from one extracorporeal circuit to the other through the common venous sinus, deleterious warming of the exposed brain during circulatory arrest, and thrombosis of both pump oxygenators. Both infants survived, although recovery was complicated in each by neurologic injury, cranial wound infection, and hydrocephalus. This case demonstrates the valuable supportive role of cardiopulmonary bypass and hypothermic circulatory arrest and in the management of complex surgical problems of otherwise inoperable patients.

Original languageEnglish (US)
Pages (from-to)961-967
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume98
Issue number5 II SUPPL.
StatePublished - 1989

Fingerprint

Conjoined Twins
Cardiopulmonary Bypass
Exsanguination
Oxygenators
Nervous System Trauma
Air Embolism
Sternotomy
Craniotomy
Wound Infection
Hydrocephalus
Blood Volume
Hypothermia
Thrombosis
Wounds and Injuries
Brain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Cameron, D. E., Reitz, B. A., Solomon, B., Long, D. M., Dufresne, C. R., Vander Kolk, C., ... Castaneda (1989). Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest. Journal of Thoracic and Cardiovascular Surgery, 98(5 II SUPPL.), 961-967.

Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest. / Cameron, D. E.; Reitz, B. A.; Solomon, Benjamin; Long, D. M.; Dufresne, C. R.; Vander Kolk, Craig; Maxwell, L. G.; Tilghman, D. M.; Nichols, D. G.; Wetzel, R. C.; Rogers, M. C.; Walton Lillehei, C.; Castaneda.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 98, No. 5 II SUPPL., 1989, p. 961-967.

Research output: Contribution to journalArticle

Cameron, DE, Reitz, BA, Solomon, B, Long, DM, Dufresne, CR, Vander Kolk, C, Maxwell, LG, Tilghman, DM, Nichols, DG, Wetzel, RC, Rogers, MC, Walton Lillehei, C & Castaneda 1989, 'Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest', Journal of Thoracic and Cardiovascular Surgery, vol. 98, no. 5 II SUPPL., pp. 961-967.
Cameron, D. E. ; Reitz, B. A. ; Solomon, Benjamin ; Long, D. M. ; Dufresne, C. R. ; Vander Kolk, Craig ; Maxwell, L. G. ; Tilghman, D. M. ; Nichols, D. G. ; Wetzel, R. C. ; Rogers, M. C. ; Walton Lillehei, C. ; Castaneda. / Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest. In: Journal of Thoracic and Cardiovascular Surgery. 1989 ; Vol. 98, No. 5 II SUPPL. pp. 961-967.
@article{a09b26a05cfd4fb68f833b8196028e5a,
title = "Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest",
abstract = "Occipitally joined craniopagus Siamese twins were separated with the use of cardiopulmonary bypass and hypothermic circulatory arrest. The 7-month-old infants shared a large sagittal venous sinus that precluded conventional neurosurgical approach because of risk of exsanguination and air embolism. After craniotomy and preliminary exposure of the sinus, each twin underwent sternotomy and total cardiopulmonary bypass with deep hypothermia. Hypothermic circulatory arrest allowed safe division and subsequent reconstruction of the sinus remnants. Several unusual problems were encountered, including transfusion of a large blood volume from one extracorporeal circuit to the other through the common venous sinus, deleterious warming of the exposed brain during circulatory arrest, and thrombosis of both pump oxygenators. Both infants survived, although recovery was complicated in each by neurologic injury, cranial wound infection, and hydrocephalus. This case demonstrates the valuable supportive role of cardiopulmonary bypass and hypothermic circulatory arrest and in the management of complex surgical problems of otherwise inoperable patients.",
author = "Cameron, {D. E.} and Reitz, {B. A.} and Benjamin Solomon and Long, {D. M.} and Dufresne, {C. R.} and {Vander Kolk}, Craig and Maxwell, {L. G.} and Tilghman, {D. M.} and Nichols, {D. G.} and Wetzel, {R. C.} and Rogers, {M. C.} and {Walton Lillehei}, C. and Castaneda",
year = "1989",
language = "English (US)",
volume = "98",
pages = "961--967",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "5 II SUPPL.",

}

TY - JOUR

T1 - Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest

AU - Cameron, D. E.

AU - Reitz, B. A.

AU - Solomon, Benjamin

AU - Long, D. M.

AU - Dufresne, C. R.

AU - Vander Kolk, Craig

AU - Maxwell, L. G.

AU - Tilghman, D. M.

AU - Nichols, D. G.

AU - Wetzel, R. C.

AU - Rogers, M. C.

AU - Walton Lillehei, C.

AU - Castaneda,

PY - 1989

Y1 - 1989

N2 - Occipitally joined craniopagus Siamese twins were separated with the use of cardiopulmonary bypass and hypothermic circulatory arrest. The 7-month-old infants shared a large sagittal venous sinus that precluded conventional neurosurgical approach because of risk of exsanguination and air embolism. After craniotomy and preliminary exposure of the sinus, each twin underwent sternotomy and total cardiopulmonary bypass with deep hypothermia. Hypothermic circulatory arrest allowed safe division and subsequent reconstruction of the sinus remnants. Several unusual problems were encountered, including transfusion of a large blood volume from one extracorporeal circuit to the other through the common venous sinus, deleterious warming of the exposed brain during circulatory arrest, and thrombosis of both pump oxygenators. Both infants survived, although recovery was complicated in each by neurologic injury, cranial wound infection, and hydrocephalus. This case demonstrates the valuable supportive role of cardiopulmonary bypass and hypothermic circulatory arrest and in the management of complex surgical problems of otherwise inoperable patients.

AB - Occipitally joined craniopagus Siamese twins were separated with the use of cardiopulmonary bypass and hypothermic circulatory arrest. The 7-month-old infants shared a large sagittal venous sinus that precluded conventional neurosurgical approach because of risk of exsanguination and air embolism. After craniotomy and preliminary exposure of the sinus, each twin underwent sternotomy and total cardiopulmonary bypass with deep hypothermia. Hypothermic circulatory arrest allowed safe division and subsequent reconstruction of the sinus remnants. Several unusual problems were encountered, including transfusion of a large blood volume from one extracorporeal circuit to the other through the common venous sinus, deleterious warming of the exposed brain during circulatory arrest, and thrombosis of both pump oxygenators. Both infants survived, although recovery was complicated in each by neurologic injury, cranial wound infection, and hydrocephalus. This case demonstrates the valuable supportive role of cardiopulmonary bypass and hypothermic circulatory arrest and in the management of complex surgical problems of otherwise inoperable patients.

UR - http://www.scopus.com/inward/record.url?scp=0024429948&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024429948&partnerID=8YFLogxK

M3 - Article

C2 - 2682024

AN - SCOPUS:0024429948

VL - 98

SP - 961

EP - 967

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 5 II SUPPL.

ER -