Girl born with two heads dies after pioneering surgery fails

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The Independent Online

An infant girl who was born with two heads died yesterday, shortly after surgeons said they had successfully removed her second, partially formed head.

Seven-week-old Rebeca Martinez, who was born with one of the world's rarest birth defects, had just survived a complex 13-hour operation at a specialist surgical unit in the Dominican Republic without obvious problems.

Soon after the team of neurosurgeons had predicted she was likely recover, the infant bled to death, roughly 12 hours after the surgery finished. Her mother, Maria Gisela Hiciano, said: "She was too little to resist the surgery." One of the two lead surgeons involved in the procedure, Dr Benjamin Rivera, said she had had numerous transfusions to replace blood lost during the operation, but that her blood would not clot.

"In that case, you can't do anything. This is the worst complication that can happen in this kind of surgery," he said.

Rebeca was born on 10 December with the extremely rare condition craniopagus parasiticus, carrying the partially developed head of a twin on the top of her skull. Only seven cases had been previously documented, but none had survived the womb.

In what doctors believed is the first operation its kind, a team of 18 surgeons, anaesthetists and nurses worked in relays for nearly 13 hours on Friday to detach the second head, which had its own partially formed brain, ears, eyes and lips.

The team had to cut off undeveloped tissue, clip the veins and arteries joining both heads, and close off Rebeca's skull using a bone and skin graft from the second head.

Earlier yesterday, Dr Santiago Hazim, the medical director of Santo Domingo's Centre for Orthopedic Specialties, where the surgery was performed, had said: "The girl is doing great. The surgery is over and her head has been closed."

Soon afterward, her father, Franklin Martinez, 29, told reporters: "We are super happy. This is what we hoped for and it happened. The only new thing now is that she'll be coming home without the extra part she used to have."

The $100,000 operation was funded by a US charity, Cure International, which owns the surgical unit involved because Mr Martinez and Ms Hiciano, 26, only make about $200 a month from their jobs as a tailor and supermarket cashier. They already have two children, aged four and one.

The couple were told the operation was essential because the second head was outgrowing Rebeca's head and would severely impair their daughter's future.

Although the operation was unprecedented, it was carried out by an extremely experienced team led by Dr Jorge Lazareff, director of pediatric neurosurgery at the UCLA Mattel Children's Hospital in California, and Dominican surgeons Dr Hazim and Dr Rivera. Dr Lazareff led the surgical team that successfully separated the Guatemalan twin girls, Maria Teresa and Marie de Jesus Quiej-Alvarex, conjoined at the head last year.

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