_ ,
Joine&at, eart, `:tlui@s,. isewred
                                                                i 6


By Howard S. Shapiro
Inquirer Staff Writer

A girl Siamese twin; less than a monthg
old. was in stable condition yesterday after a
Z&member medical team at Children's HOST
pita1 separated her from her sister in an
operation lasting more than seven hours. ,
The other girl died ap lo:40 a.m., an hour
and a quarter after surgery started.
The twins were joined from just below the
collarbone to the ,navel, like 40 percent of allI
Siamese twins. What made these girls ex-
`tremely unusual was that they shared a heart.
A normal heart has four chambers, but
these twins had six chambers - two in the
body of the girl who died, four in the body of
tie surviving girl.

  The surgeons could snot safely alter the
heart, se they decided before the operation to
leave -the full six-chambered heart in `the
body of the girl who survives.      ,
Althoughthe family approved the operation, *
`the physicians said that because one of the
twins was certain to die, they obtained a
court order Monday.

Children's Hospital `aides' said there `had
been only six known surgical separations of
,`Siamese twins joined at the heart ,and that
only three of those were described in medical
literature. Only one person has survived.
The twins were taken Into the operating
~room,shortly after 6 a.m., yesterday, and the'~
team began to administer `uresthetics. Surge-
ry did not begin until Y:25 a.m. Two hours
  >

Philadelphia Inwirer / AKIRA SUWA

Afterward, muses Debbi O'Leary I1 efti ,and Macky McDonald show tension

later, the bodies `were fully separated and  tion had not been performed.
doctors began to build a chest wall from the   Even so, Dr. koop said, the surviving girl
remaining ribs, then stitch the surviving in-  had only a 5 percent to 10 percent chance of
fant, a process that ended at about 1:30 p.m.  staying alive after the separation. "Right
Dr., C. Everett Koop, chief surgeon at the
hospital I and leader of the -team that per-  now, I feel very hopeful," he said at a news
                   conference yesterday afternoon after the
formed the separation,' said that both girls  operation was. completed,
would have died in a short time if the opera-       (See TWINS on 7-A),


Joined:at heart,' twins severed
at ChildrenkHospital; 1. dies
                                                                           f

TWINS, From 14

At the request of the twins'. par-
ents, Dr. Koop would not supply any
information about the family, includ-
ing the name, and reporters were not
permitted' to see the surviving infant.

Koop did say that the twins had
been born by cesarean section on
Sept. 15, and that the mo:her was
still recovering. The father was at
the hospital during the operation, he
said.

A New Jersey newspaper reported
two weeks ago that the twins
we?e born at Monmouth Medical Cen-
ter in Long, Branch, N. J., and that
the parents were residents of New
Jersey. The babies had a combinld
weight of 8 pounds, 10 ounces at
birth, and were immediately trans-
ported to the infant intensive-care unit
at Children's Hospital to be treated
for respiratory problems.

For two weeks, surgeons and other
physicians at' Children's examined
the infants and designed a plan for
the separation. Except for the joined.
,heart, doctors found that each girl
had most of her own organs, Dr.
Koop said.
He said that the living girl wpinhcd
about 7% pounds after the operation.

Dr. Koop, who also headed the
Children's Hospital team that ;epa-
rated the Rodriguez twins, from the
Dominican Republic, in 1974, said yes-
terday's operation was technically
easier because not as many organs
were joined.
"But this operation , `was fraught
with far greater danger because it
was the heart that was involved,"
he said. One of the Rodriguez girls,
now 4, remains -alive. The other died
in an incident unrelated to the sep:
aration.
Yesterday's operation was the third
separation of Siamese twins ever per-

The resources of Children's Hospital are marshaled

formed at Children's Hospital. A girl
also remains alive from the first op-
eration, done in 1957.
One in every 60,000 births is Sia-
mese twins. The name comes from
tmhe first widely publicized pair,
which was from Siam and became a
circus act. Few ever live long enough
to undergo a separation operation.

Dr. Russell C. Raphaely, the Chil-
dren% Hospital anesthesiologist re.
sponsible for monitoring the living

girl's safety, said she was breathing
yesterday afternoon with `the help of
a machine that fed air through a hole
in her windpipe.

If doctors determine that the
amount of oxygen in the infant's
blood is appropriate, they will re-
move the machine today, he said.
The infant, who was described as not
heavily bandaged, remained under
anesthetics late yesterday.