Separated twins doing well

NEW YORK – Two-year-old twins from the Philippines born with the tops of their heads fused together were “strong and stable” after being separated in a marathon operation that stretched into early Thursday.

Carl and Clarence Aguirre remained under heavy sedation in side-by-side beds but were expected to awaken later in the day – the first time in their short lives that they would see each other apart, their jubilant doctors said.

“A huge step in this remarkable process has been accomplished,” said Dr. Spencer Foreman, president of Montefiore Medical Center, at a news conference a few hours after the 17-hour operation wrapped up.

The boys were surgically separated at the Montefiore Children’s Hospital late Wednesday, and the operation was completed at about 3:15 a.m. Thursday, filling the room with joy and relief, lead surgeon Dr. James Goodrich said. “It was hard to ignore the moment,” he said.

Dr. David Staffenberg, the boys’ plastic surgeon, delivered word of the separation to their mother, Arlene Aguirre, said hospital spokeswoman Pamela Adkins.

In a private waiting area, Staffenberg got on his knees, took Aguirre’s hands and said, “You’re now the mother of two boys,” Adkins said. Aguirre burst into tears, she said.

Staffenberg pronounced the boys “strong and stable.” Concerns in the coming week are infection or a leak of cerebral spinal fluid, Goodrich said.

During the surgery, doctors teased apart abutting portions of the boys’ brains after completing an incision around their skull, and the twins’ head-to-head operating tables were then slightly pulled apart, said hospital spokesman Steve Osborne.

Reconstruction of the boys’ skulls, a major project, is to be left for later.

It is likely to be months before the twins’ conditions can be fully assessed, their doctors said. In the past, separation was considered a success if both twins simply survived. But Montefiore aimed for “viable, independent lives” for the Aguirre boys.

The separation was the culmination of a gradual surgical approach that lasted 10 months, a departure from the marathon operations that have separated other conjoined twins.

Over four major surgeries since October, the boys’ separate-but-touching brains were gently pushed apart and the tangle of blood vessels they shared were cut and divided.

Between surgeries, the boys were given time to heal and to adapt to their rerouted circulation systems. Originally, veins near Clarence’s brain were doing much of the circulation work for both boys, but scans showed dormant veins on Carl’s side had “plumped up” and begun working in response to the surgery, lead surgeon Dr. James Goodrich said last week.

Aguirre had sent the feisty dark-haired boys into the operating room with tearful kisses at about 7:30 a.m. She placed a small figure of the Virgin Mary on her sons’ gurney, and it stayed with them, on an instrument cart, through the surgery.

Associated Press

Carl and Clarence Aguirre lie in separate beds for the first time after surgery to separate them Thursday in New York.

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