Doctors call off surgery to separate twin girls

It’s unclear whether the girls will return to Romania or stay in the U.S.

CLEVELAND (AP) — Their parents and doctors had hoped that, one day soon, 3-year-old twin girls born joined at the head would for the first time be able to look each other in the eyes.

Tatiana and Anastasia Dogaru and their Romanian parents traveled from Italy to Dallas to Cleveland looking for a way to separate the girls, and doctors at Rainbow Babies and Children’s Hospital had done an initial surgery.

But, after reviewing medical tests performed on the girls after that surgery, they concluded the medical risks were too great to move ahead with further plans to separate the two.

The hospital announced Monday that it has called off the separation surgery and said it doubts the situation will change because of medical complications suffered by the girls.

“We are, of course, worried that the girls could develop complications over time if they are not separated, as have other children with this condition,” Dr. Nathan Levitan, chief medical officer of the hospital’s parent, University Hospitals Case Medical Center.

“However, in the judgment of our team of physicians, the risk of proceeding with separation is too great.”

The decision was made last week after doctors reviewed the results of weeks of tests done on the girls, Levitan said.

The top of Tatiana’s head is attached to the back of Anastasia’s. Anastasia, the bigger twin, has no kidney function and relies on Tatiana’s kidneys.

The girls’ were born in Italy to 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.

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In a videotaped statement played at a news conference at the hospital, they said 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.

Alin Dogaru said the family appreciated the hospital’s consideration of their concern that neither girl face a significant risk.

“We want to thank them, the medical team, for being aware of this and stopping at the right time,” he said.

The videotape showed Alin Dogaru watching the girls undergo testing and both parents with the girls in a playground.

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 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.

Dr. James Tait Goodrich of New York’s Montefiore Medical Center, who separated conjoined twins in 2004, said the complexity of the Dogaru case made the decision understandable.

“There are a lot of extenuating circumstances here that could have seriously led to the demise of both children or even if they had survived, been in a much more compromised state than they are in now at present,” said Goodrich, who has consulted on the Dogaru case.

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.

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.