MEDICINE / HISTORIC SURGERY

Twins with joined hearts separated

Siriraj hospital yesterday announced the world's first successful separation of conjoined twins whose hearts and livers were connected.

Ten-month-old Pantawan and Panwad Thiyenjai were born by caesarean section last June, joined from the top of the chest to the bottom of the abdomen.

The right atrium chamber of elder sister Pantawan's heart was connected to Panwad's left atrium. Their blood circulation was also connected.

"This is the first time in the world that twins who were connected by their hearts and livers have survive an operation to separate them," said Dr Mongkol Laohapensang, a pediatrician and member of the team which performed the 12-hour operation.

Dr Mongkol said Panwad still needed special care as she had breathing difficulties and a hole in the atrium wall.

"She will undergo further surgery when her heart is stronger," said the doctor.

The elder twin, Pantawan, is in great shape.

The twins were separated in late February, when they were eight months old. The hospital delayed making an announcement about the procedure until doctors were sure that the girls had a good chance of survival.

The procedure involved 61 medical staff - including 14 anaesthesiologists, seven plastic surgeons, five heart surgeons and five paediatric surgeons. All of them are Thai.

Dr Mongkol said doctors decided to perform the operation after thorough examinations showed that the twins' hearts were not dependent on each other.

First-time mother Usa Thiyenjai, 29, said she agreed to the risky operation because she felt such pity for her babies.

"When they slept, the body of the younger twin was lifted high up from the mattress because she is smaller. Their heads became flat because they could sleep only on one side," said Ms Usa, who learned during her pregnancy that she was carrying conjoined twins.

Though she felt sad about it, she had received good support and treatment from the hospital, she said.

At birth the twins had a total weight of 3,450 grammes.

"At first, the doctors told me to prepare to lose one or both of my twins [after the operation]. But they did it. I am so thankful to the doctors and nurses," she said.

Ms Usa has to travel about 70km from Samut Songkhram to Bangkok every day to see her daughters at the hospital.

"I don't mind the journey between my home and the hospital. I just want to be with them every day," she said.

Bangkok Post

Friday April 06, 2007