Twin-twin transfusion syndrome, coarctation of the aorta and hypoplastic aortic arch: a case series report

Journal of Paediatrics and Child Health
Jutta van den BoomTim Hornung

Abstract

The twin-twin transfusion syndrome (TTTS) complicates 10-30% of monochorionic pregnancies. The incidence of pulmonary stenosis and endocardial fibroelastosis is especially high in the recipient twin. We report a novel finding of four cases of coarctation of the aorta and hypoplastic aortic arch in the donor to raise awareness of cardiac lesions in twins affected by TTTS. Retrospective review of both neonatal database and mortality data from 2002 to 2007 with cross-validation from the local tertiary cardiology unit data (1998-2006) to identify children presenting with coarctation who were also twins. We identified four monochorionic twin pairs affected by the TTTS, delivered between 25 weeks and 36 weeks' gestation, where the donor was found to have coarctation of the aorta or a hypoplastic aortic arch. In addition, two of the four recipients also had cardiac abnormalities. There was a high mortality rate of 30% for both twins, and a high morbidity rate, especially for neurological sequelae. We believe that the types of abnormalities seen may be explained by the altered fetal blood flow and haemodynamics in TTTS. Given the increased prevalence of congenital heart disease in TTTS, with an increased risk of coarctation in the dono...Continue Reading

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Citations

May 24, 2011·Journal of Paediatrics and Child Health·David G Beevers, Gregory Yh Lip
Sep 3, 2010·International Journal of Pediatrics·Tim Van MieghemJan Deprest
Apr 19, 2016·Twin Research and Human Genetics : the Official Journal of the International Society for Twin Studies·Nicky Manning, Nick Archer
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Mar 11, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Manon GijtenbeekArend D J Ten Harkel
Jun 27, 2019·Journal of Clinical Medicine·Manon GijtenbeekMonique C Haak
Sep 16, 2020·Pediatrics International : Official Journal of the Japan Pediatric Society·Emiko TakeokaHideto Nakao
Oct 17, 2021·Pediatric Cardiology·Iyad Al-AmmouriWadah M Khriesat

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