Pulmonary Artery Calcification in Recipient Twins of Twin to Twin Transfusion Syndrome: A Report of Three Cases

Twin to twin transfusion syndrome may rarely complicate monochorionic twin gestation, resulting in discordant size of the twins. Cardiac dysfunction and various types of cardiac defects have been described in the recipient twin of this syndrome. Pulmonary artery calcification has been described earlier in one case only. We report three recipients of twin to twin transfusion syndrome with pulmonary artery calcification resulting in obstruction of pulmonary trunk in two of these. One case with progressive severe narrowing was successfully operated at four months of age with patch repair of pulmonary artery. He is doing well three years later. The obstruction is moderate in the other case. Calcification in the wall of pulmonary artery may be secondary to vascular injury sustained as a result of volume overloading of the circulation of the recipient twin.