Chiu C.-T.Hou S.-H.HONG-SHIEE LAIPO-HUANG LEELin F.-Y.Chen W.-J.Chen M.-T.Lin T.-W.Chu S.-H.2020-02-242020-02-2419940021-9509https://www.scopus.com/inward/record.uri?eid=2-s2.0-0028600618&partnerID=40&md5=c357bf1b691d41a4c45f4503b325f483https://scholars.lib.ntu.edu.tw/handle/123456789/462559A pair of thoracopagus conjoined twins with a connection at the atrioventricular groove of both hearts and a huge conjoined liver were surgically separated. An aortopulmonary shunt was created for Twin B, a victim of complex congenital heart disease with hypoplastic right heart syndrome, who died 5 hours later. However, Twin A survived after prolonged endotracheal intubation and parenteral nutrition. He survived for 7 months, and went home, but finally died of sepsis. In reviewing 47 pairs of surgically separated thoracopagus conjoined twins, in 30 pairs of type A (Leachman's classification, completely separate hearts), 42 patients survived (70%); in 5 pairs of type B (atrial connection only), one patient survived (10%); in 9 pairs of type C (both atrial and ventricular interconnections), none survived; in 3 pairs of unknown type, 2 survived. Total survival rate of surgically separated thoracopagus conjoined twins was 47.9%. The survival rate was 38.2% in those operated in the neonatal period (n = 34) and 63.6% in those operated over 1 month of age (n = 44) (p = 0.016). In conclusion, thoracopagus conjoined twins are rare. Although its separation carries a high risk, especially in those with cardiac connection, this report confirmed that separation is still feasible under proper preparation and planning.[SDGs]SDG3article; case report; congenital heart malformation; conjoined twins; endotracheal intubation; heart; human; infant; liver; male; parenteral nutrition; sepsis; shunting; survival rate; Case Report; Electrocardiography; Fatal Outcome; Heart Defects, Congenital; Human; Infant; Liver; Magnetic Resonance Imaging; Male; Methods; Tomography, X-Ray Computed; Twins, Conjoinedjournal article79958412-s2.0-0028600618