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‘Little miracles’ survive historic separation surgery

Posted at 1:03 PM, Apr 23, 2013
and last updated 2013-04-24 06:57:47-04

RICHMOND, Va. (WTVR) - A pair of six-month-old conjoined twins were surgically separated at Children’s Hospital of Richmond at VCU, doctors announced Tuesday. The 14-hour operation started Monday morning.

“We’re very optimistic that the twins will have a full and complete recovery,” David Lanning, M.D., Ph.D., surgeon-in-chief at the Children’s Hospital of Richmond at VCU, said in a statement. “At this point we don’t anticipate any future operations or need for any long term medications. I see the girls living full happy lives as individuals.”

In separating A’zhari and A’zhiah Jones, of Franklin, Virginia, doctors divided the children's liver. Doctors said the children were joined at the abdomen and heart.

Lanning said there are no published reports of successful, phased-separation surgeries of twins who share vital organs and conjoined at the abdomen and heart.

This is not the first time doctors at VCU have separated conjoined twins. In 2011, doctors separated 19-month-old conjoined twins, Maria and Teresa Tapia of the Dominican Republic.

“While A’zhari and A’zhiah look similar to the Tapia twins from the outside, we were faced with a different set of challenges that we had to overcome as a team,” Lanning said in the statement. “Despite these differences, our experience with the Tapia twins has been vitally helpful with caring for the Jones twins.”

When the twins' mother was 13 weeks pregnant, she learned her daughters were conjoined. She gave birth to the girls in October. Five days later doctors learned the twins were joined at the liver and a shared pericardium.

Doctors said they performed the first stage of the phased separation on Oct. 25 when they separated the conjoined liver.

“As the girls became critically ill over the second week of their lives, we had to urgently separate their conjoined liver as this was the source of their uncompensated cross circulation. However, complete separation at that time would almost assuredly have resulted in their deaths as A’zhari was in renal failure and A’zhiah had severe cardiac hypertrophy. A phased surgery was the optimal plan,” Lanning said.

Doctors monitored the girls health over the next few months.

In February surgeons placed tissue expanders in the twins’ abdomens, allowing extra skin to grow. That skin was later used in reconstructive surgery.

“We made the decision to proceed with the final separation once the girls gained weight and their renal and heart problems resolved,” said Lanning.

The girls are now recovering in separate rooms in the Neonatal Intensive Care Unit. Doctors said the girls eventually will be reunited in one room.

“It has been one hard journey, like a roller-coaster,” mother Nachell Jones said. “Some days it’s great and other days it’s hard. Today is one of the great days. They are my little miracles.”