Anesthetic Management for Thoracopagus Twins with Complex Cyanotic Heart Disease in the Magnetic Resonance Imaging Suite

Abstract

In Brief We report a case of thoracopagus twins undergoing magnetic resonance imaging (MRI) studies under general anesthesia. The twins had a complex shared cardiac anatomy that posed additional challenges to an already-difficult anesthesia care area. This report emphasizes the approach to anesthetic management of conjoined twins in the MRI environment. IMPLICATIONS: In this article we discuss the approach to and management of conjoined twins in the magnetic resonance imaging scanner. The twins shared a complex cardiac circulation, making the choice of anesthetic technique very important. In addition, their position—facing each other and attached chest to chest—made airway management difficult.