Closing arterial ducts in the neonatal nursery by an echocardiographically guided cardiac catheter technique with minimal morbidity is becoming achievable and is a significant advance in neonatal care.

No abstract

The incidence of structural heart disease in MC twins is increased, independent of TTTS. This justifies referral of these pregnancies for detailed fetal echocardiography as part of their assessment. If one twin is affected, the risk to the other twin is increased further.

No abstract

This review addresses the physiology of monochorionic diamniotic (MC/DA) twins and the potential for twin-twin transfusion syndrome (TTTS). It focuses on the underlying cardiovascular pathophysiology of TTTS and the cardiovascular impact of TTTS for both the recipient and the donor twin. It explains the principles for assessment and monitoring of these cardiovascular changes and how these may be used to guide pregnancy management. Finally, it describes the effect of treatment on the altered hemodynamics and how this can influence pregnancy and perinatal management, as well as longer-term follow-up.