Doctors Permanently Halt Twins' Separation Surgery

CLEVELAND (AP) - Surgery to separate twins joined at the head has been permanently called off because the medical risk to the 3-year-old girls is too high, Rainbow Babies and Children's Hospital said Monday.

While Tatiana and Anastasia Dogaru can develop life-threatening complications if they remain conjoined, the risk of proceeding with the long-planned separation surgery is too great, said Dr. Nathan Levitan, chief medical officer of the hospital's parent, University Hospitals Case Medical Center.

The top of Tatiana's head is attached to the back of Anastasia's and they have never been able to look each other in the eye. Anastasia, the bigger twin, has no kidney function and relies on Tatiana's kidneys.

The girls' were born in Italy to Romanian parents Alin Dogaru, a Byzantine Catholic priest, and his wife, Claudia, who have said they viewed separation surgeries as the girls' best hope. But the decision to cancel plans complied with their wish to avoid any procedure that could harm either girl.

They said in a videotaped statement played at a Monday news conference at the hospital that they were thankful for the care the girls had received. Claudia Dogaru said she and her husband believe they had made the best decision on behalf of the girls.

Levitan, asked about the girls' survival prospects, said only 14 similar twins have been reported in the past half century, and just 10 percent had reached age 11.

While medicine continues to make progress, "no one can predict the future," he said.

An initial surgery in the process to separate the twins on June 6 was halted because of brain swelling and low blood pressure.

Medical tests since the aborted surgery showed the hearts of both girls are overworking - Tatiana's as if to overcome a blockage and Anastasia's to deal with low blood pressure.

The girls arrived in Cleveland on April 3 from Dallas, where they had been evaluated, to begin testing to determine whether they could undergo separation surgery.

Levitan said the risks to the conjoined girls include infection and heart failure.

"These types of problems are very hard to manage," he said.

The twins have already beaten the odds by living this long. Most twins joined at the head die at birth, according to the hospital.

They are doing well at home, walking and playing, Levitan said.

The hospital is working with the family to decide whether the girls will return to Romania or stay in the U.S., who will provide medical care and who will pay for it.

Levitan said the doctors involved in the case felt they had done the best they could to give the girls a chance to be separated.

"I expect we will all keep in touch with them," he said.