Surgery on twins likely to resume this week

Cardiac problems arose in one of the 13-month-olds

September 13, 2004|By David Kohn | David Kohn,SUN STAFF

The surgery to separate 13-month-old conjoined twins likely will resume later this week, after being halted Saturday night due to a complication, a Johns Hopkins Children's Center spokeswoman said yesterday.

The procedure was stopped Saturday night, seven hours into the operation, when one of the twins - who are joined at the top of the head - developed cardiac problems. Surgeons stopped the surgery, and the cardiac problem stabilized.

"The surgeons said, `We're not going to push it. We're going to be safe,'" according to spokeswoman Stacy Vernick Goldberg. "The team is very confident the surgery will go forward."

Before the problem arose, the surgeons had made a lot of progress, she said.

Plastic surgeons had inserted expanders to protect the girls' scalp tissue, which must be stretched to cover the separated heads. After that, neurosurgeons began cutting into their skulls. About four hours into the surgery, doctors had cut through and opened the dura, the fibrous covering of the brain. They were working to separate the major blood vessels shared by the girls when the vital signs of one became unstable.

The doctors decided to halt the surgery. They sewed up the incisions, but the twins remain under general anesthesia in the pediatric intensive care unit at the children's center.

Goldberg said the medical team was confident the surgery would succeed, as long as the twins' vital signs remained stable. She said that many of the 50 surgeons and other medical professionals involved in the endeavor will have to juggle their schedules this week. The surgery was to have taken 48 hours.

Lea and Tabea were born connected at the top of their heads. They have individual brains but share several cranial blood vessels. The condition - called craniopagus - occurs once in about 2 million births.

The twins are celebrities in their hometown of Lemgo, Germany, where thousands of people have raised money to help finance the attempt to separate them.

They were brought to Baltimore to be operated on by the team being led by Dr. Benjamin S. Carson, head of pediatric neurosurgery at the children's center. He has performed the procedure four times previously, with the patients surviving in two of them.

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