Conjoined twin girls who were connected at heart and liver are successfully separated in pioneering two-stage surgery


  • A’zhari and A’zhiah Jones, now six months old, were born connected at the chest with a shared a liver and pericardium – the fluid-filled sac around the heart and major blood vessels
  • There are no published reports of successful, phased-separation surgeries of conjoined twins sharing vital organs and conjoined at the abdomen

By SADIE WHITELOCKS

PUBLISHED: 14:18 EST, 25 April 2013 | UPDATED: 14:18 EST, 25 April 2013

Two six-month-old formerly conjoined twin girls are recovering at a Virginia hospital, following a pioneering two-stage operation to separate them.

A’zhari and A’zhiah Jones, who are currently being monitored at the Children’s Hospital of Richmondwere born connected at the chest with a shared a liver and pericardium – the fluid-filled sac around the heart and major blood vessels.

They underwent the first phase of their separation surgery in October, but due to ill-health the final part of the complex procedure was postponed until this Monday.

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Success story: Conjoined twins A'zhari (pink bow) and A'zhiah (blue bow) gaze at the camera before going in for the final part of their separation surgery - the procedure took 14 hours Success story: Conjoined twins A’zhari (pink bow) and A’zhiah (blue bow) gaze at the camera before going in for the final part of their separation surgery – the procedure took 14 hours

Doctors say the pair have made a full recovery from the 14-hour treatment and there should be no need for future intervention or long-term medication.

Surgeon-in-chief Dr David Lanning, said in a statement on Tuesday: ‘We’re very optimistic that the twins will have a full and complete recovery . . . I see the girls living full happy lives as individuals.’

 

The girls were born on October 10, 2012, through a planned cesarean section to Nachell Jones and Carlos Lawrence, of Franklin, Virginia. They weighed a combined 10 pounds.

Ms Nachell was 12 weeks pregnant when she learned she was expecting twins and a week later scans revealed that the fetuses were conjoined. 

Surprise: Ms Nachell was 12 weeks pregnant when she learned she was expecting twins and a week later scans revealed that the fetuses were conjoinedSurprise: Ms Nachell was 12 weeks pregnant when she learned she was expecting twins and a week later scans revealed that the fetuses were conjoined

Team effort: More than 40 surgeons and pediatric specialists participated in the 14-hour surgery Team effort: More than 40 surgeons and pediatric specialists participated in the 14-hour surgery

In the second week of their life A’zhari and A’zhiah’s health deteriorated, prompting doctors to begin the first surgery to divide their fused liver on October 25.

‘To complete separation at that time would almost assuredly have resulted in their deaths’

While the surgery was successful, doctors could not continue with full separation due to the infants’ illnesses.

A’zhari had renal failure and her sister had severe cardiac hypertrophy – a thickening of the heart muscle which can lead to congestive heart failure.

‘[To] complete separation at that time would almost assuredly have resulted in their deaths,’ Dr Lanning said.

Center of attention: A nurse and A'zhari's parents watch over and smile as the six-month-old formerly conjoined twin rests on the Neonatal Intensive Care Unit at the Children's Hospital of RichmondCenter of attention: A nurse and A’zhari’s parents watch over and smile as the six-month-old formerly conjoined twin rests on the Neonatal Intensive Care Unit at the Children’s Hospital of Richmond

Going solo: On Monday, for the first time in their lives, the twin girls were separated Going solo: On Monday, for the first time in their lives, the twin girls were separated

 

With her daughters’ futures looking bleak Ms Jones told News Channel 3: ‘I was sad . . . I was crying.’

‘It has been one hard journey, like a roller-coaster. Some days it’s great and other days it’s hard’

However once their condition improved and they had gained weight doctors began planning for the next stage of their treatment.

On February 14, tissue expanders were placed in the twins’ abdomens. The balloon-like devices enabled the growth of excess skin to be used for closure and reconstruction post-surgery.

On Monday morning this week, a team of 40 specialists and staff members led by Dr Lanning began the final separation process.

 

Final touch: Excess skin was used to close the girls' chests post-surgeryFinal touch: Excess skin was used to close the girls’ chests post-surgery

 

Mother, Ms Jones, explained that she was optimistic about the surgery: ‘I was ready, I have good faith. I didn’t have anything to worry about.’

The operation started around 6.45am and 14 hours later, the girls, for the first time in their lives, were separated and moved to different rooms in the neonatal intensive care unit to recover.

Doctors say they are currently in a stable condition and will be reunited in the coming months.

According to Dr Lanning, while phased-separation surgeries of twins conjoined at the head or hips have been successful, there are no published reports of successful, phased-separation surgeries of those sharing vital organs and conjoined at the abdomen and heart like the Jones girls.

On the road to recovery: Doctors say the twins are stable and will be reunited in the coming monthsOn the road to recovery: Doctors say the twins are stable and will be reunited in the coming months

It was the second separation of conjoined twins performed at the Children’s Hospital of Richmond at in the last 18 months.

In November 2011, Dr Lanning and a large team of specialists successfully separated 19-month-old conjoined twins, Maria and Teresa Tapia of the Dominican Republic, in a complex 20-hour procedure.

Ms Jones praised the staff at the children’s hospital.

‘The nurses are very caring and like my family. They are very supportive of me and the girls. It’s like they are their own kids.’

Summing up her challenging journey into motherhood, she said: ‘It has been one hard journey, like a roller-coaster. Some days it’s great and other days it’s hard. Today [Monday] is one of the great days. They are my little miracles.’

Read more: http://www.dailymail.co.uk/femail/article-2314779/Conjoined-twin-girls-connected-heart-liver-successfully-separated-pioneering-stage-surgery.html#ixzz2RWTbtis3


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