Twin sisters in Brazil who were born conjoined at the head died shortly after doctors completed a fifth and highly complex operation to separate them, according to a report.
Heloísa and Helena Batista da Silva, both 2, shared brain tissue and blood vessels and suffered a severe decline after the procedure in Ribeirão Preto on Saturday, including inadequate blood flow to their organs and cardiac arrest, the UK Sun reported.
The young sisters had just been separated following a 15-hour surgery when their conditions suddenly worsened, the outlet said.
Doctors reportedly saw opposite and alarming changes in the girls’ vital signs, with one twin developing dangerously low blood pressure while the other experienced high blood pressure.
Helena then suffered a heart attack at 11:12 p.m., followed by Heloísa at 11:26 p.m., according to the report.
The medical team tried for 25 minutes to revive the sisters, but they were pronounced dead soon afterward, the outlet reported.
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“They had many bouts of pneumonia, they had a tracheostomy, they needed a gastrostomy for feeding, and they had episodes that also weakened their bodies,” said Jayme Farina Júnior, a plastic surgeon who was part of the team.
“But at the moment of the final separation, their bodies could not withstand this instability, and then they progressed to cardiac arrest.”
The twins’ first three surgeries involved doctors separating around 75% of their shared brain tissue and blood vessels.
During the fourth operation, doctors used tissue expanders to increase the amount of skin needed for closing their skulls in the final separation.
The sisters had successfully completed four surgeries over the past year before the final surgery, which required more than 50 staffers at the hospital.
Both girls reportedly suffered haemodynamic instability, also known as insufficient blood flow to vital organs, which can lead to organ failure and death.
Their father, Amarildo Batista da Silva, thanked the doctors and hospital staff despite the heartbreaking outcome.
The girls were buried on Aug. 16 in São José dos Campos near their family home.