Thoracic Conjoined Twins

Conjoined twins have been the subject of fascination for much of human history (Geroulanos et al., Gesnerus 50(Pt 3-4):179-200, 1993). These twins have been viewed, at best, as curiosities and, worse, as “monstrosities.” Until recently, medical intervention was not possible. Advances in medical and surgical therapies have allowed for improved outcomes of these patients, including successful surgical separations in some instances (Hoyle, Surg Gynecol Obstet 170:549-562, 1990). However, due to the often significantly interconnected nature of their hearts, treatment options for thoracopagus twins (joined from the anterior thorax to the umbilicus) have remained particularly limited (Collins et al., Pediatr Cardiol 33:252-257, 2012). In this chapter we discuss the incidence, anatomy, and the different treatment options for conjoined twins with thoracopagus.