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Siamese Twins Separated; One Baby Dies : Medicine: 7-week-old Amy succumbs as sister Angela is given the malformed heart they shared. Doctors say her survival chances are slim.

August 21, 1993|From Associated Press

PHILADELPHIA — Doctors sacrificed 7-week-old Amy Lakeberg in a 5 1/2-hour operation Friday that gave her Siamese twin sister, Angela, sole possession of their shared, malformed heart--and a slender hope of survival.

Angela was resting comfortably after the separation surgery, and her doctors said that they were hopeful. Amy died about two-thirds of the way through the operation.

Before the surgery, nurses had painted Angela's fingernails pink and left her sister's bare. The infant twins' parents interpreted that as a sign--Amy would die to give Angela a narrow chance at life.

Family members said their goodbys Friday morning before the surgical team at the Children's Hospital of Philadelphia began the operation.

"It's hard to say goodby to a living person," said the twins' father, Kenneth Lakeberg.

Although doctors originally estimated that the operation could take 20 hours, they finished in 5 1/2. Angela was in critical condition.

"Angela is stable, comfortable and we hope that will continue to be the case," said Dr. James A. O'Neill Jr., the lead surgeon. "Obviously, we're sad that Amy could not be a part of continuing with her sister. That's the difficult part for us and her family.

"It is obviously too early to predict what the outcome will be, but it is encouraging so far."

Before the operation, O'Neill said that the choice of which infant must die would be based on anatomy. The shared heart was insufficient to keep both alive for more than a few more weeks, doctors said.

Surgeons began operating at 8:05 a.m. and reported from the operating room that they completed the first part of the operation--separating the twins' liver tissue--by late morning. Doctors then moved on to reconstructing the six-chambered heart, a task they called daunting. A normal heart has four chambers.

Kenneth Lakeberg and his wife, Reitha Lakeberg, of Wheatfield, Ind., stayed in seclusion in the hospital during the operation.

Afterward, the father said, "I honestly didn't think either one would make it out of the operating room."

He confused the twins' names as he described how doctors told him and his wife that the operation was completed.

"They came in and said it was over. Within an hour we were in there with Amy. She kind of peeked her eyes open. Angela, I'm sorry."

The twins' aunt, Georgia Welsh, said of the parents: "Today it hit them. . . . They took it really hard today. They kissed them and they hugged them, and then they said goodby."

Welsh sat outside the hospital, crying occasionally and talking about her nieces. She made funeral arrangements for Amy Lakeberg over a cellular phone.

"We wished the very best to Amy. We know God's with her," Welsh said. "I told her I loved her and I thanked her for the time that we had."

In one hand, Welsh clutched a plaster imprint of both the twins' two-inch hands, made before they were anesthetized for surgery. In the other, she held a clown doll that the twins played with during their last moments together.

The operation was the fourth at the hospital on conjoined twins with shared hearts. The longest survivor, separated in 1977, died of liver failure after three months.

O'Neill acknowledged that the chances of survival for Angela were slim. He said, however, that surgery would not have been recommended had there not been a reasonable chance.

The twins were born June 29 at Loyola University Medical Center in suburban Chicago. Doctors there opposed separation.

Lakeberg, who was hired by a welding company in mid-July after a year without work, and his wife brought their daughters to Philadelphia on Tuesday. They have no insurance to cover the hundreds of thousands of dollars in costs. Indiana Public Aid provides $997 per day, and Children's Hospital has said it will absorb the rest.

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