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CNN BREAKING NEWS

Conjoined Twins Die

Aired July 8, 2003 - 06:41   ET

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

KRIS OSBORN, CNN ANCHOR: Well first some expertise now on the tragic news, the death of the two Iranian Bijani twins in Singapore just within the last several hours.
We are joined by CNN medical correspondent Dr. Sanjay Gupta who is himself a neurosurgeon.

Doctor, obviously very sad news for the families, for the loved ones, some of whom had flown in from Iran, but let's talk about some of what might have gone wrong.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Yes, well you know all along they've been talking about the fact that this is the first time this has ever been done on adults, that is the separation of conjoined twins, so I don't think anybody really knew fully what to expect here.

Your question is the right one, Kris, what went wrong? And it's hard to say exactly what happened at this point. Everyone is pointing to blood loss as being the problem. And what happens typically in these sorts of situations, because of a few different factors, the pressure within the brain starts to rise. And if you can imagine that, Kris, sort of the pressure within the brain starting to rise, actually forcing some of the blood through some of the newly cut surfaces now as the brain was being separated.

One of the critical parts of this operation that we have been talking about for so long was actually rerouting some of these veins to try and allow enough blood drainage for both the twins. There was only one vein where there should have been two and that was obviously a problem. That hurdle had been crossed yesterday, over 12 hours ago now, but unfortunately, the increased pressure, the constant bleeding proved to be too much, first for Ladan Bijani and then Laleh Bijani. Certainly a huge problem controlling bleeding being one of the biggest problems in any sort of neurosurgical case.

We do have some calls in to the doctors already. They're obviously, you know, still tied up finishing up things there in the operating room, but we'll get some details.

OSBORN: Well, Doc, I imagine the medical complexity of an undertaking such as this has to be just extraordinary when you think of the elite neurosurgeons there, and as you were referring to, making some progress I understand going millimeter by millimeter through the skulls. Talk to us about, put in context for us some of the additional complications and challenges that they would face trying to separate these brains, the tissue. GUPTA: That's right. This is one of the biggest sort of operations in neurosurgery, probably operations period. Over 100 medical personnel, including anesthesiologists, plastic surgeons, vascular surgeons, neurosurgeons, all working literally around the clock now over two days to try and get this done.

I actually spoke to Ben Carson several times in the past. He's a neurosurgeon from Johns Hopkins. He has actually done this procedure before. One of the things that he said to me in the past that struck me was the actual dividing of some of the tissues here, as you refer to, is sort of like cutting a piece of paper along its edge. And you can imagine how thin a piece of paper is and exactly -- it gives you a little bit of perspective in what kind of cutting actually needs to be done. If you get off one way or the other, you can cause catastrophic bleeding, which is sounds like what happened, first with Ladan and then -- and then Laleh.

OSBORN: Thank you so much. CNN medical correspondent Dr. Sanjay Gupta providing expertise on, unfortunately, what is a very tragic circumstance.

GUPTA: Yes. Thank you.

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