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American Morning

Twins' Tragedy

Aired July 08, 2003 - 08:45   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: It was a tragic operation, ending earlier today in the deaths of these two conjoined twins, sisters joined at the head for 29 years. The operation, that marathon operation, ended earlier today, and so, too, did the lives of both of these young women. There was a lot of hope thrown in this operation, but in the end, medically speaking, physically speak, just too great an obstacle to overcome.
Dr. Sanjay Gupta, our own neurosurgeon, tracking that from the beginning, back with us live at the CNN Center.

Sad news, Sanjay. Good morning again.

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

Very sad news indeed. You know, unprecedented operation. This had never been done before. I don't think anybody really knew fully what to expect. Some of the early obstacles proved actually very doable by the surgeon, including Dr. Ben Carson, here from the United States. They actually had to create a blood vessel where one did not exist before. That was what they thought would be the rate-limiting step for the operation. In fact, they got through that part OK. What likely happened now from the doctors now, Bill, is that that bypass, that vein graft they created was blocked off and was not allowing blood to pass through it, and that subsequently caused the brain to swell and to bleed.

Both twins first moved on six hours ago, and then Laila (ph), just a couple of hours after that dying from profound blood loss as a primary reason.

Again, Bill, this had never been done before, and there are so many medical firsts anymore. This was the first time it had ever been attempted, and unfortunately, it did result in this tragic loss, but a lot of thing his been learned from this already -- Bill.

HEMMER: It had been done with infant, but never with adults, especially at age of 29. What does that is a about how precarious these things can be with adults?

GUPTA: As the brains age, as the twins age, their brains become fused together. One of the things that surgeons learned was the blood supply between the two brains much more sort of interdependent, one on the other, than they probably thought. As they created this bypass, they altered the circulation of the blood in the brains, and that made it very, very difficult at times to control the bleeding. As was pointed out by you, the brains were actually separated, but so much bleeding had occurred by that time that it was difficult to keep up with. And I'll add as well, Bill, this was one of those sort of interesting situations in neurosurgery in particular, oftentimes the surgeons having to give blood thinners at the same time they are operating on the brain. The problem is obvious there. You're giving a blood thinner that's going to cause bleeding, especially in the wake of a recent operation. So really, playing catch-up the entire time, it sounds like, and unfortunately, resulting in what you see there.

HEMMER: Sanjay, in your conversations with this doctor, Ben Carson, did he ever express to you the possibility that it could happen and could take place and be done successfully?

GUPTA: Sure. We talked it him and asked him that same question, and he was, I think, appropriately reserved on that comment. Again, no precedent here. So it's not like he can say, well, out of a thousand cases, 500 do well. There were no cases to look at as far as adults go in the past.

He said 50/50. That's what he said to me -- I give it a 50/50 chance that this is going to work, and a 50 percent chance that they may die from this, and obviously, we saw the latter, but Tee (ph) was also sort of reserved about this.

Another interesting thing Dr. Carson described to me was actually the separating of the actual brain tissue. It's kind of like cutting through this piece of paper along the lengthwise. Millimeters in size, very difficult to cut through. To get too far one way or the other, you can cause dramatic bleeding, and that also probably contributed to what we saw today.

HEMMER: And to think the surgery was elective from the very beginning. They wanted to live separate lives, not to be in Singapore.

Thank you, Sanjay. Sanjay Gupta from the CNN Center.

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 - 08:45   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
BILL HEMMER, CNN ANCHOR: It was a tragic operation, ending earlier today in the deaths of these two conjoined twins, sisters joined at the head for 29 years. The operation, that marathon operation, ended earlier today, and so, too, did the lives of both of these young women. There was a lot of hope thrown in this operation, but in the end, medically speaking, physically speak, just too great an obstacle to overcome.
Dr. Sanjay Gupta, our own neurosurgeon, tracking that from the beginning, back with us live at the CNN Center.

Sad news, Sanjay. Good morning again.

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

Very sad news indeed. You know, unprecedented operation. This had never been done before. I don't think anybody really knew fully what to expect. Some of the early obstacles proved actually very doable by the surgeon, including Dr. Ben Carson, here from the United States. They actually had to create a blood vessel where one did not exist before. That was what they thought would be the rate-limiting step for the operation. In fact, they got through that part OK. What likely happened now from the doctors now, Bill, is that that bypass, that vein graft they created was blocked off and was not allowing blood to pass through it, and that subsequently caused the brain to swell and to bleed.

Both twins first moved on six hours ago, and then Laila (ph), just a couple of hours after that dying from profound blood loss as a primary reason.

Again, Bill, this had never been done before, and there are so many medical firsts anymore. This was the first time it had ever been attempted, and unfortunately, it did result in this tragic loss, but a lot of thing his been learned from this already -- Bill.

HEMMER: It had been done with infant, but never with adults, especially at age of 29. What does that is a about how precarious these things can be with adults?

GUPTA: As the brains age, as the twins age, their brains become fused together. One of the things that surgeons learned was the blood supply between the two brains much more sort of interdependent, one on the other, than they probably thought. As they created this bypass, they altered the circulation of the blood in the brains, and that made it very, very difficult at times to control the bleeding. As was pointed out by you, the brains were actually separated, but so much bleeding had occurred by that time that it was difficult to keep up with. And I'll add as well, Bill, this was one of those sort of interesting situations in neurosurgery in particular, oftentimes the surgeons having to give blood thinners at the same time they are operating on the brain. The problem is obvious there. You're giving a blood thinner that's going to cause bleeding, especially in the wake of a recent operation. So really, playing catch-up the entire time, it sounds like, and unfortunately, resulting in what you see there.

HEMMER: Sanjay, in your conversations with this doctor, Ben Carson, did he ever express to you the possibility that it could happen and could take place and be done successfully?

GUPTA: Sure. We talked it him and asked him that same question, and he was, I think, appropriately reserved on that comment. Again, no precedent here. So it's not like he can say, well, out of a thousand cases, 500 do well. There were no cases to look at as far as adults go in the past.

He said 50/50. That's what he said to me -- I give it a 50/50 chance that this is going to work, and a 50 percent chance that they may die from this, and obviously, we saw the latter, but Tee (ph) was also sort of reserved about this.

Another interesting thing Dr. Carson described to me was actually the separating of the actual brain tissue. It's kind of like cutting through this piece of paper along the lengthwise. Millimeters in size, very difficult to cut through. To get too far one way or the other, you can cause dramatic bleeding, and that also probably contributed to what we saw today.

HEMMER: And to think the surgery was elective from the very beginning. They wanted to live separate lives, not to be in Singapore.

Thank you, Sanjay. Sanjay Gupta from the CNN Center.

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