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CNN Live At Daybreak

One of Conjoined Iranian Twins Dies

Aired July 08, 2003 - 05:03   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


KRIS OSBORN, CNN CORRESPONDENT: Well, as we've been talking about this morning, one of the conjoined Iranian twins has died. Ladan Bijani died in a Singapore hospital less than two hours after being separated from her sister Laleh. Now, the twins had been on the operating table for two and a half days as an international team of doctors worked vigorously to separate their fused brains. Blood loss led to the death.
(BEGIN VIDEO CLIP)

DR. PREM KUMAR NAIR, RAFFLES HOSPITAL: Raffles Hospital regrets to announce that Ladan Bijani passed away a few minutes ago. As the separation was coming to a close, a lot of blood was lost. Despite the best efforts of the medical team, the twins were subsequently in a critical state. Doctors attempted to stabilize her, but her condition continued to deteriorate. Laleh, meanwhile, is critically ill and doctors are still trying to stabilize her.

(END VIDEO CLIP)

OSBORN: Her sister, as you just heard there, remains in critical condition.

For more on this story, let's discuss it with freelance journalist Michael Dwyer.

He joins us live in Singapore.

Hello to you, of course, under very sad circumstances there.

I guess first thing, anything new on Laleh and her condition? She's still alive. How is she doing? Is she going to make it?

MICHAEL DWYER, JOURNALIST: We do believe that she's in a critical situation. We haven't been given any new information since it was revealed that Ladan unfortunately passed away around about 4:00 p.m. Singapore time.

It's been a very emotional afternoon in Singapore. We had been told earlier on that the operation was going slowly, but was progressing steadily and successfully. And then shortly before 4:00 p.m., all of that changed. In quick succession, there were two unscheduled press conferences. Firstly it was revealed that the twins were in a critical situation, that there was a large loss of blood when the two brains were successfully separated. And then shortly after that, it was revealed that Ladan Bijani has unfortunately passed away -- Kris. OSBORN: Very unfortunate, indeed.

And, Michael, I imagine you've been hearing continuously about the difficulty of this operation. I wanted to ask you about the background for these kinds of procedures.

I understand that in Germany in 1996 some doctors didn't want to do it, citing the risks involved. But this team believed to have better technology.

Some of your thoughts on that?

DWYER: This team has had success in the past. Dr. Keith Goh, who is the chief neurosurgeon leading this team, had success in 2001 when in Singapore, Nepalese twins who were conjoined at the head were successfully separated.

However, they were babies and it's a much more complex operation to separate adults. What they found when they opened up the skull was that the 29-year-old brains were sitting side by side and they had fused together. It made it a very difficult operation.

To separate them they had to go in millimeter by millimeter, making small cuts, prying the brains apart, trying not to cut through veins, cut through arteries and cause damage to the brains.

Unfortunately, it seems that too much blood was lost.

This team was approached by the twins after they found out about the successful operation in the year 2001. They had been searching for surgeons for a long time to perform this operation. They were very glad to come to Singapore. They were adamant that the operation should go ahead, even after Dr. Goh tried to convince them that it was too risky. They did want separate lives and unfortunately for Ladan, the risk hasn't paid off.

OSBORN: Well, Michael, and as you had referred to moments ago, throughout the course of this procedure, there was at certain points some cause for cautious optimism as that key vein had been successfully separated using the vein graft from a thigh.

DWYER: That's correct. On Sunday, one of the first parts of the procedure was to harvest two sections of vein from Ladan's thigh. After they did that, some time later, after gaining access to the skull, to the brains inside the skull, they were able to create a bypass. The purpose of that was to create separate blood supplies to the two brains.

A major critical aspect of the separation was separating that blood supply. The two brains were supported by one major blood supply and they needed the bypass operation to be successful.

When it was announced that they had been successful, it was seen to be a very positive move and neurosurgeons were then able to move in to try and separate the two brains. But in the end for Ladan it hasn't been a successful day. OSBORN: No, and a very sad one, of course.

Michael Dwyer, a freelance journalist, joining us live from Singapore.

Thank you very much.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired July 8, 2003 - 05:03   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KRIS OSBORN, CNN CORRESPONDENT: Well, as we've been talking about this morning, one of the conjoined Iranian twins has died. Ladan Bijani died in a Singapore hospital less than two hours after being separated from her sister Laleh. Now, the twins had been on the operating table for two and a half days as an international team of doctors worked vigorously to separate their fused brains. Blood loss led to the death.
(BEGIN VIDEO CLIP)

DR. PREM KUMAR NAIR, RAFFLES HOSPITAL: Raffles Hospital regrets to announce that Ladan Bijani passed away a few minutes ago. As the separation was coming to a close, a lot of blood was lost. Despite the best efforts of the medical team, the twins were subsequently in a critical state. Doctors attempted to stabilize her, but her condition continued to deteriorate. Laleh, meanwhile, is critically ill and doctors are still trying to stabilize her.

(END VIDEO CLIP)

OSBORN: Her sister, as you just heard there, remains in critical condition.

For more on this story, let's discuss it with freelance journalist Michael Dwyer.

He joins us live in Singapore.

Hello to you, of course, under very sad circumstances there.

I guess first thing, anything new on Laleh and her condition? She's still alive. How is she doing? Is she going to make it?

MICHAEL DWYER, JOURNALIST: We do believe that she's in a critical situation. We haven't been given any new information since it was revealed that Ladan unfortunately passed away around about 4:00 p.m. Singapore time.

It's been a very emotional afternoon in Singapore. We had been told earlier on that the operation was going slowly, but was progressing steadily and successfully. And then shortly before 4:00 p.m., all of that changed. In quick succession, there were two unscheduled press conferences. Firstly it was revealed that the twins were in a critical situation, that there was a large loss of blood when the two brains were successfully separated. And then shortly after that, it was revealed that Ladan Bijani has unfortunately passed away -- Kris. OSBORN: Very unfortunate, indeed.

And, Michael, I imagine you've been hearing continuously about the difficulty of this operation. I wanted to ask you about the background for these kinds of procedures.

I understand that in Germany in 1996 some doctors didn't want to do it, citing the risks involved. But this team believed to have better technology.

Some of your thoughts on that?

DWYER: This team has had success in the past. Dr. Keith Goh, who is the chief neurosurgeon leading this team, had success in 2001 when in Singapore, Nepalese twins who were conjoined at the head were successfully separated.

However, they were babies and it's a much more complex operation to separate adults. What they found when they opened up the skull was that the 29-year-old brains were sitting side by side and they had fused together. It made it a very difficult operation.

To separate them they had to go in millimeter by millimeter, making small cuts, prying the brains apart, trying not to cut through veins, cut through arteries and cause damage to the brains.

Unfortunately, it seems that too much blood was lost.

This team was approached by the twins after they found out about the successful operation in the year 2001. They had been searching for surgeons for a long time to perform this operation. They were very glad to come to Singapore. They were adamant that the operation should go ahead, even after Dr. Goh tried to convince them that it was too risky. They did want separate lives and unfortunately for Ladan, the risk hasn't paid off.

OSBORN: Well, Michael, and as you had referred to moments ago, throughout the course of this procedure, there was at certain points some cause for cautious optimism as that key vein had been successfully separated using the vein graft from a thigh.

DWYER: That's correct. On Sunday, one of the first parts of the procedure was to harvest two sections of vein from Ladan's thigh. After they did that, some time later, after gaining access to the skull, to the brains inside the skull, they were able to create a bypass. The purpose of that was to create separate blood supplies to the two brains.

A major critical aspect of the separation was separating that blood supply. The two brains were supported by one major blood supply and they needed the bypass operation to be successful.

When it was announced that they had been successful, it was seen to be a very positive move and neurosurgeons were then able to move in to try and separate the two brains. But in the end for Ladan it hasn't been a successful day. OSBORN: No, and a very sad one, of course.

Michael Dwyer, a freelance journalist, joining us live from Singapore.

Thank you very much.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com