VIDEO: Conjoined twins separated at the University of Minnesota
On February 10, 2017, Paisleigh and Paislyn Martinez were born at the University of Minnesota Masonic Children’s Hospital. They were born thoraco-omphalopagus conjoined twins. Only one in 200,000 live births result in conjoined twins.
“When I was pregnant with them they were basically saying they weren’t sure they would make it,” said Paris Bryan, mother of Paisleigh and Paislyn.
“We met mom and dad in the prenatal clinic with our maternal fetal medicine clinics. And after an ultrasound discovered (the babies) were conjoined twins,” explained Pediatric Surgeon Daniel Saltzman, M.D., Ph.D.
“It just scared me pretty bad because I didn’t know how complicated it could have been,” remembered the girls’ father, Ernesto Martinez.
Paisleigh and Paislyn were joined from the lower two-thirds of their breastbones to their belly buttons. Their hearts appeared to touching, and were later found to be connected, and their livers were fused in the middle.
“It’s just scary too with how their hearts are and everything right now,” said Martinez.
The care team knew they needed more in-depth and advanced imaging, so they called upon the Earl E. Bakken Medical Devices Center at the University of Minnesota.
“Having conversations with our pediatric radiologist, we were able to do 3-D reconstructions in conjunction with the pediatric cardiologist, pediatric cardiac surgeon, the pediatric radiologist, and then our medical device center colleagues,” explained Saltzman.
Three-dimensional imaging, courtesy of a device that only exists in 5 places worldwide and was created at the center by graduate students, allowed the surgeons and other experts to essentially take a 3-D tour of the girls hearts. They were able to use these scans to create 3-D models of the hearts as well.
“What we found in the 3-D model, which was based from a CT scan, if you flip the heart around there was a moderate to large connection or communication between the right atrium of Paislyn and the left atrium of Paisleigh. What we had to do was separate this moderate to large communication,” said Pediatric Cardiothoracic Surgeon Tony Azakie, M.D.
Saltzman went on to further explain, “It actually changed our planning with how we were going to position the infants on the operating table and how we were going to approach it.”
That included flipping the orientation of the twins 180 degrees on the operating table. The team conducted “simulations,” practicing in the operating room eight times before the surgery. They brought the 3-D models in with them and also created dolls to represent the twins to use in the practices.
“We anticipated every little problem we were going to have, we have everything down to where we are going to put monitors, how we are going to transport them how we are going to close them, close the skin, and put the dressings on,” Saltzman explained after the final simulation before the surgery.
About a week before the separation surgery was scheduled, the girls’ mom was eager for this next step for her girls. “I’m excited. I’m waiting for the separation and basically going forward from this. To show them you know it is possible for conjoined twins to have everything that everyone else has,” said Bryan.
On May 25 2017, about 40 surgeons, nurses, doctors and medical experts spent nine hours in the operating room with Paislyn and Paisleigh. The twins were successfully separated.
“To see how everyone has just sort of fallen into that piece of the puzzle, and it’s truly part of a greater good, and everyone is working toward that greater good is really amazing,” said Saltzman.
“They continued to be connected somehow spiritually or emotionally or physiologically, there continues to be that connection, but the fact that using modern technology and using current surgical strategies and medical care, that you can separate them and separate them safely, it is somewhat awe inspiring,” said Azakie.
Now they begin what will be a long road to recovery. But as with their entire journey so far, they won’t be tackling it alone. They have an entire team at the University of Minnesota backing them up.
“It’s been an amazing experience. And what has been the most amazing is how the entire team has come together," said Saltzman.
“It’s been a really great journey,” Bryan said, as she smiled.