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New York City, New York (February 19, 2004) -- Conjoined Filipino twins Carl and Clarence Aguirre tomorrow morning will undergo what surgeons at The Children’s Hospital at Montefiore (CHAM) are calling “the most delicate and complex surgery yet” in the series of surgeries designed ultimately to separate the 22-month old boys, who were born joined at the tops of their heads. The operation, expected to be a lengthy one lasting most of the day Friday, is the boys’ third surgery at CHAM since their arrival in the New York area from the Philippines with their mother, Arlene, on Sept 10, 2003.
“There are two major shared veins remaining to tie off, which makes this operation the riskiest to date,” said James T. Goodrich, MD, chief of pediatric neurosurgery at CHAM, and one of the two lead surgeons on the twins’ medical team. “We expect to tie off one of these major veins in this operation,” said Dr. Goodrich. “We are mindful of the risks of excessive bleeding, stroke, swelling of the brain or other serious consequences. We also know, as does the boys’ mother, Arlene, that this surgery is medically necessary if the boys are to have any chance of a normal life.”
The two remaining large shared veins -- part of the sagittal sinus -- are an abnormal network of shared veins that have formed what appears to be a “pool” of blood between the boys’ brains. The sagittal sinus is key to the drainage of blood from the brain back to the heart. Without sufficient independent drainage and blood circulation, neither boy can survive.
“After tying off one of the shared veins in this procedure, we expect to assign the “pool” to Clarence, who was born with a more developed venous system than his brother Carl,” said Dr. Goodrich. Surgeons then will continue to reroute the blood flow in Carl’s brain into deeper, existing veins.
New MRI and CT scans show that, as Dr. Goodrich and his partner, Dr. David Staffenberg, chief of pediatric plastic surgery, CHAM, had postulated, existing veins have begun to "plump up" in Carl’s brain, becomming more prominent with the increased volume of blood flow. This indicated to Drs. Goodrich and Staffenberg that the time was right to surgically reroute Carl’s blood flow from one of the remaining major shared veins into the newly expanded capacity of his own existing veins.
“Ultimately, the goal is for both Carl and Clarence to form completely independent venous systems,” said Dr. Staffenberg.
The surgery is expected to last throughout the day. No comment is expected from the medical center until after the surgery is completed, and any available information will be distributed through this website
Plans for a Saturday morning media briefing will be posted sometime Friday evening, and a b-roll package from the surgery will be available at that time. Please stay tuned. In the meantime, on this site we will provide media with new 3-D holographic images and graphics, photos, and for the first time make available an animation package that shows precisely the surgical procedure planned for Friday’s operation.
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