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CNN BREAKING NEWS

Conjoined Iranian Twins Die

Aired July 8, 2003 - 06:02   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

KRIS OSBORN, CNN ANCHOR: We have some breaking news to tell you about this morning. We've just received word that both conjoined twins have died in a Singapore hospital during the operation to separate them. Ladan Bujani died on the operating table just a few hours ago. The death of her sister, Laleh, was announced just moments ago.
Now, the news was met with great sadness by people in Singapore, who had followed the sisters' story, leading up to and including the two-and-a-half day operation. Doctors linked the death to blood loss.

(BEGIN VIDEO CLIP)

DR. PREM KIMAR NAIR, RAFFLES HOSPITAL SPOKESMAN: Raffles Hospital regrets to announce that Ladan Bujani passed away a few minutes ago. As the separation was coming to a close, a lot of blood was lost. Despite the best efforts of the medical team, the twins were subsequently in a critical state. Doctors attempted to stabilize her, but her condition continued to deteriorate.

Laleh, meanwhile, is critically ill, and doctors are still trying to stabilize her.

(END VIDEO CLIP)

OSBORN: We want to go now to journalist Michael Dwyer, who's been covering this story in Singapore.

Very sad news -- Michael.

MICHAEL DWYER, JOURNALIST: It has been a very sad afternoon here in Singapore. We had been led to believe that the operation was going slowly, but was going successfully. But when the bad news came, it did come very fast. We found out through two unscheduled press conferences firstly that the twins were in a critical situation due to a loss of blood when the surgeons were separating the two brains. Shortly after that we found out that one of the twins had passed away.

There is a report that the second of the twins has also died. That report hasn't yet been confirmed by the hospital. We're expecting a press conference in the next 10 minutes or so -- Kris.

OSBORN: Michael Dwyer, thank you very much for that report.

And with this sad news, let's bring in the expertise of Dr. Sanjay Gupta, who is himself a neurosurgeon and quite familiar with these procedures. Sanjay -- very sad news.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Very sad indeed. You know, again, Kris, we've been saying all along this is the first time this has ever been attempted, this sort of operation, the separation of conjoining twins on adults. And certainly no one really knew what to expect for sure at any point (UNINTELLIGIBLE).

I can just tell you that we had talked so much yesterday about the surgeons heading up through one of the critical parts of the operation to actually re-establish some of the blood supply. But unfortunately it sounds like what happened as well is that during the very, very difficult task of separating the brains, there was in fact so much bleeding that first Ladan and then it sounds like Laleh as well succumbed to that blood loss.

OSBORN: And, Doc, if you can help for us put in context, some of the reports about the operation were describing an unstable pressure situation inside the skulls as this was moving forward.

GUPTA: Think about it like this: These two brains have been fused together for 29 years. There are several things sort at work here. First of all, there are two brains that are in the skull size of really one-and-a-half. So that's going to raise some of the pressure within the intracranial cavity. Also, you know, once this blood was rerouted, it takes some time for the two brains to get used to the blood not being where it's supposed to be anymore, and that does create an unstable sort of pressure situation.

But I think what really probably caused this problem, Kris, was just the very arduous task of having to separate two brains that had essentially fused together for 29 years. If you think about trying to separate a piece of cheese, for example, very, very carefully, millimeter by millimeter, if you get too far one way or the other you can cause catastrophic bleeding. And it sounds like that that's what happened here.

OSBORN: When I imagine, Doctor, that there would be a lot of tissue that was fused together, along with veins and of course the skull, bleeding in the brain can be, of course, very fatal, very serious.

GUPTA: That's right. I mean, bleeding in the brain is the most serious of anywhere in the body, and certainly when you have brains fused together like that you're more likely to get bleeding.

And let me add as well, Kris, you know, I think you and I talked about this, the blood vessel situation yesterday, it is important sometimes for the surgeons to actually put the patients on blood thinners in order to prevent those blood vessels from developing clots. Now, you can imagine, Kris, the inherent problem in that right away if you've got someone on blood thinners that you're also operating on, you're even more likely to get bleeding. And, again, it sounds like that that's what ultimately the problem was here.

OSBORN: CNN's medical correspondent, Dr. Sanjay Gupta, thank you very much for joining us on the phone and bringing some of your valued expertise into this tragic circumstance with, of course, the death of the Bijani twins.

We are told as well on this there will be a news conference in Singapore some time soon. We will bring it to you live the moment it happens.

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