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

D. E. Cameron, B. A. Reitz, B. S. Carson, D. M. Long, C. R. Dufresne, C. A. 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.
DOIs
StatePublished - 1989

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest'. Together they form a unique fingerprint.

  • Cite this

    Cameron, D. E., Reitz, B. A., Carson, B. S., Long, D. M., Dufresne, C. R., Vander Kolk, C. A., Maxwell, L. G., Tilghman, D. M., Nichols, D. G., Wetzel, R. C., Rogers, M. C., Walton Lillehei, 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. https://doi.org/10.1016/s0022-5223(19)34279-5