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American Morning

Double Tragedy in Deaths of Conjoined Twins

Aired July 08, 2003 - 07:04   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.


BILL HEMMER, CNN ANCHOR: Operation hope ended this morning with a double tragedy. After 29 years of living with their heads fused, the conjoined twins briefly separated, then both died shortly after that marathon surgery was under way.
Dr. Sanjay Gupta with us again this morning. Said to be precarious at the start, Doctor. In the end, it proved to be a bit worse than that.

Good morning.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Bill.

You know, it had never been done before on adults -- that is, separating of conjoined twins. So, certainly I don't think anybody knew fully what to expect. All of the things you said, Bill, are absolutely correct.

There were a couple of major obstacles which were crossed early on in the operation for these twins. First of all, this blood vessel that we have been talking so much about had, in fact, been rerouted. I was just listening to some of the comments from the doctors just a few minutes ago, and they said that that -- even though that blood vessel had been rerouted, a lot of pressure was still building up in the brain of one of the twins. And they actually had to create another bypass, to in fact create another blood vessel to drain even more of the blood.

The problem being, Bill, as we ultimately ended up seeing, was that if there's too much pressure in the brain, the brain starts to bleed sort of more diffusely all over the brain. And, in fact, that's exactly what happened after the separation had occurred first to Ladan and then Laleh Bijani, Ladan a few before Laleh passed on due to profound bleeding. And it sounds like Laleh also experienced that same sort of bleeding.

These are the sorts of complications, the sorts of problems in neurosurgery that are the most difficult to control. Bleeding in the brain can be extremely challenging. We're talking about blood vessels that are microscopic in size. We're talking about making cuts, as Ben Carson once described to me, length-wise along a piece of paper, very, very fine, very, precise, and really very little room for error. If there is error, this sort of bleeding can occur as well.

So, obviously sort of a tragic outcome here at best. When we spoke to Ben Carson before the operation, he said 50/50. As it turns out it wasn't -- it didn't turn out to be well for either twin -- Bill.

HEMMER: You touched on it briefly there, and you've talked about this ever this since the procedure began, the amount of tissue and growth that happens after essentially two brains grow together and live together for 29 years. Was that the breaking point that left this tissue so delicate and so difficult to separate?

GUPTA: I think that that was a lot of it, no question. Twenty- nine years of fusion of one brain to the other is very different than the fusion of two newborn brains, for example. That made it very, very difficult. The brains had sort of grown together, making those cuts, again, very, very challenging.

And imagine this, Bill: tangles of blood vessels that the surgeons would encounter as they're making these cuts even making it more challenging. But, again, that pressure inside the brain causing that excessive bleeding probably also contributed to this.

We're going to -- we've got some calls in. We're going to get some of the details and get back to you as soon as we can -- Bill.

HEMMER: All right, thank you, Sanjay. We'll talk to you later this morning. Tough news again out of Singapore.

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 - 07:04   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
BILL HEMMER, CNN ANCHOR: Operation hope ended this morning with a double tragedy. After 29 years of living with their heads fused, the conjoined twins briefly separated, then both died shortly after that marathon surgery was under way.
Dr. Sanjay Gupta with us again this morning. Said to be precarious at the start, Doctor. In the end, it proved to be a bit worse than that.

Good morning.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Bill.

You know, it had never been done before on adults -- that is, separating of conjoined twins. So, certainly I don't think anybody knew fully what to expect. All of the things you said, Bill, are absolutely correct.

There were a couple of major obstacles which were crossed early on in the operation for these twins. First of all, this blood vessel that we have been talking so much about had, in fact, been rerouted. I was just listening to some of the comments from the doctors just a few minutes ago, and they said that that -- even though that blood vessel had been rerouted, a lot of pressure was still building up in the brain of one of the twins. And they actually had to create another bypass, to in fact create another blood vessel to drain even more of the blood.

The problem being, Bill, as we ultimately ended up seeing, was that if there's too much pressure in the brain, the brain starts to bleed sort of more diffusely all over the brain. And, in fact, that's exactly what happened after the separation had occurred first to Ladan and then Laleh Bijani, Ladan a few before Laleh passed on due to profound bleeding. And it sounds like Laleh also experienced that same sort of bleeding.

These are the sorts of complications, the sorts of problems in neurosurgery that are the most difficult to control. Bleeding in the brain can be extremely challenging. We're talking about blood vessels that are microscopic in size. We're talking about making cuts, as Ben Carson once described to me, length-wise along a piece of paper, very, very fine, very, precise, and really very little room for error. If there is error, this sort of bleeding can occur as well.

So, obviously sort of a tragic outcome here at best. When we spoke to Ben Carson before the operation, he said 50/50. As it turns out it wasn't -- it didn't turn out to be well for either twin -- Bill.

HEMMER: You touched on it briefly there, and you've talked about this ever this since the procedure began, the amount of tissue and growth that happens after essentially two brains grow together and live together for 29 years. Was that the breaking point that left this tissue so delicate and so difficult to separate?

GUPTA: I think that that was a lot of it, no question. Twenty- nine years of fusion of one brain to the other is very different than the fusion of two newborn brains, for example. That made it very, very difficult. The brains had sort of grown together, making those cuts, again, very, very challenging.

And imagine this, Bill: tangles of blood vessels that the surgeons would encounter as they're making these cuts even making it more challenging. But, again, that pressure inside the brain causing that excessive bleeding probably also contributed to this.

We're going to -- we've got some calls in. We're going to get some of the details and get back to you as soon as we can -- Bill.

HEMMER: All right, thank you, Sanjay. We'll talk to you later this morning. Tough news again out of Singapore.

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