Infant dies from complications following unique surgery
By Jeyling Chou
Feb. 8, 2004 9:00 p.m.
Seven-week-old baby Rebeca Martinez died over the weekend in the
Dominican Republic after a 12-hour surgery to remove the head of
her undeveloped twin, who was fused to her skull.
The surgery was led by Dr. Jorge Lazareff, director of pediatric
neurosurgery at UCLA’s Mattel Children’s Hospital, and
Dr. Benjamin Rivera, a neurosurgeon at the CURE International
Center for Orthopedic Specialties in Santo Domingo.
Rivera had asked Lazareff to participate in Rebeca’s
surgery after reading about his successful separation of two
Guatemalan twins conjoined at the head at the UCLA Medical Center
in August 2002.
The head of Rebeca’s parasitic twin had a poorly developed
brain and rudimentary ears, eyes and lips. Supplied with blood and
nutrients by one of the infant’s main arteries, the second
head was growing at a faster rate than Rebeca’s.
Without surgery, the growth would have impeded the development
of her brain, and she would not have been able to hold her head up
by the age of three months.
The surgical procedure involved a delicate separation of veins
and arteries that connected the tissues of the two heads.
The operation itself proceeded without complications and ended
with the successful closing of Rebeca’s head Friday night.
The infant was also given several blood transfusions from nearly
four gallons of blood donated by friends and family.
At 8:30 p.m. on Friday, an update on the surgery stated,
“If all goes well, Rebeca will recover in a few weeks, and
she will grow and develop as a normal child with no lasting
problems from this miracle surgery.”
In the middle of the night on Friday, the blood vessels in
Rebeca’s head began hemorrhaging, and she ultimately suffered
several heart attacks.
Doctors could not stop the blood loss, despite efforts at a
second surgery, and she passed away at 6 a.m. on Saturday.
Both neurosurgeons were aware of the risks of this type of
surgery, especially the chances of excessive bleeding.
“˜”˜This was not a failure or an error,”
Lazareff said on Saturday. “˜”˜When we left here last
night at midnight, the girl was in stable
condition.”
Lazareff and the UCLA physicians traveled to Santo Domingo at
the end of January to inspect Rebeca and decide whether to proceed
with the operation.
Lazareff was accompanied by another UCLA neurosurgeon and two
UCLA anesthesiologists who offered to donate their time. The
hospital also donated thousands of dollars of medical equipment for
the operation.
CURE, a U.S. non-profit organization that funds medical care for
disabled children in developing countries, supplied an estimated
$100,000 for the operation.
Rebeca’s parents, Maria Gisela Hiciano and Franklyn
Martinez, earned $200 a month and were unable to afford the
surgery.
“(Rebeca) had won the hearts of everyone here at CURE, and
all over the world, as we prayed for a successful outcome for her
and her family,” said Dr. Scott Harrison, CURE’s
founder and CEO, in a statement Saturday morning.
There have been eight known cases of this condition, known as
craniopagus parasiticus, and Rebeca was the only infant who
survived beyond birth.
“We knew this was a very risky surgery, and now we accept
what God has decided,” Martinez said. “Rebeca is no
longer with us, but no one will ever forget her.”
Conjoined twins are formed when an embryo fails to split
completely in the womb during the development of identical twins.
Twins that are conjoined by the head are extremely rare, occurring
only once in every 2.5 million births.
Even rarer, parasitic twins form when one of the twins stops
developing and becomes completely dependent on the other.
With reports from Bruin wire services.
