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Costa Rica Twins Separated by Docs to Return Home

Once-conjoined twins to return to Costa Rica healthy, happy; Mom says 'girls were born anew'

AP Photo

PALO ALTO, Calif.—Two-year-old twin girls walked, played and showed no visible signs that they had been joined just months earlier at the chest and abdomen. For their mother, the risky November separation surgery gave her two new daughters.

"I feel very happy and very content, because my girls were born anew in this hospital," said Maria Elizabeth Arias, speaking through a translator at the twins' first public appearance since the surgery.

Dr. Gary Hartman, who led the surgery at Lucile Packard Children's Hospital at Stanford, said the girls will likely face few complications when they return home to their native Costa Rica.

"The girls are doing well. They have healed," Hartman said.

AP Photo

Yurelia and Fiorella Rocha-Arias were connected at the right atria of their hearts, the chamber that receives blood from the rest of the body, and they shared a liver and some blood.

Conjoined twins who remain fused face major health risks, especially if they share any organs unequally. If one conjoined twin dies, the other will die within in hours, he said.

The girls arrived in San Francisco in July and began receiving weekly injections of sterile salt water into balloons placed under their skin. The procedure stretched the skin to compensate for the holes surgeons cut into their abdomens.

After the separation surgery, Yurelia needed a complex follow-up heart surgery to correct deformities that made her turn blue when she became excited or upset, doctors said.
 
After the operations, Yurelia's heart started to function normally, said Dr. Frank Hanley, who performed the heart operation. The smaller of the two, she has flourished since the operation, doctors said.

Packard doctors donated their time to treat the twins, who have nine older siblings. Hartman estimated the cost of the surgeries and treatment—which directly involved as many as 300 people—at $2 million.

Mending Kids International, a faith-based nonprofit based in Santa Clarita that helps sick children, arranged transportation and housing.

Researchers estimate the incidence of conjoined twins to be between 1 in 30,000 to 1 in 200,000 worldwide. About five separation surgeries are performed annually in the United States.

The biggest remaining health risk to the twins is the possibility of infection as their wounds from chest reconstruction surgery continue to heal, doctors said.

Both will attend physical therapy once a week for several weeks when they return home. They can expect a normal lifespan and should have no special problems having children on their own, Hartman said.

Arias said she takes joy in being able to lead her daughters by the hand and go for walks, each girl on her own. Before their separation, the girls' face-to-face position made walking nearly impossible.

Still, the twins remain inseparable, Arias said.

"They always look for each other. They sleep together," she said. "They try to be together as often as possible."

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