U.S. Doctors
to Separate Costa Rican
Two-Year-Old Twins
Joined At Chest
The Associated Press
PALO ALTO, Calif. -
Doctors at Lucile
Packard Children's
Hospital said they would
attempt to separate
two-year-old twin girls
who are conjoined at the
chest and abdomen.
Surgery on Yurelia and
Fiorella Rocha-Arias of
San José, Costa Rica, is
expected to take place
in late November, after
their skin has been
stretched to cover the
large gap where they
have been connected.
The survival rate for
separation surgery for
twins joined primarily
at the chest - known as
thoraco-omphalopagus
twins - is about 50 per
cent, doctors said
Thursday. But rates vary
widely, depending in
part on the extent of
heart defects.
"We hope to send home
two girls who are
healthy and happy," lead
surgeon Gary Hartman
said. "I can envision
these girls, a few years
from now, flipping
through a photo album
and calling mama and
saying, 'Look mama! This
is a picture of us when
we were connected."'
Since arriving in San
Francisco on July 25,
the girls have been
receiving weekly
injections of sterile
saltwater into balloons
placed beneath their
skin. This procedure
should stretch their
skin to compensate for
the hole that surgeons
will cut into their
abdomens.
The girls are connected
at the right atria of
their hearts, the
chamber that receives
blood from the rest of
the body, and they share
some blood and a single
liver.
At their age, Yurelia
and Fiorella may be
stronger and quicker to
recover than younger
twins; before coming to
California, they were
only hospitalized a few
times for colds and
respiratory infections.
But, doctors warn, their
muscle and skeletons had
more time to fuse than
younger twins who
undergo surgery,
possibly complicating
the procedure.
Because of their
face-to-face
positioning, the girls
are unable to walk, and
their backs are becoming
crooked. Although they
reach for things
together and play
peacefully, caregivers
say the toddlers are
increasingly willful and
want to do things by
themselves.
Cardiothoracic surgeon
Dr. Frank Hanley said it
was impossible to say
how long the twins would
live if the surgery did
not take place.
"It's an unfathomable
question," he said. "As
they mature, one is
probably going to grow
faster than the other,
and the discrepancies
will grow. They can't
even walk together now,
just stand up. It's more
about quality of life."
If the surgery goes
well, the girls face
more operations to
correct heart and lung
problems, and
psychological care.
Costa Rican media have
followed the girls, and
it's unclear how they
would adjust to relative
normalcy.
About five separation
surgeries are performed
annually in the United
States, according to
Packard data. On Aug.
29, doctors at
Children's Hospital of
Philadelphia separated
one-year-olds Matthew
and Andrew Goodman, who
shared a liver, pancreas
and other organs.
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