Minneapolis doctors save twins with new procedure
A pair of babies born in Minneapolis this week are among the first in the Midwest to undergo a new procedure to fix a rare, but often fatal condition shared by twins. While the fetuses were in the womb doctors discovered that one was syphoning blood from the other. They used an experimental surgery to sever the faulty connection, months before they were born.
Minneapolis, Minn. — Owen and Gavin Cassellius were longshots. The twins suffered what's known as Twin to Twin Transfusion Syndrome, in which a pair of fetuses share a placenta, but not equally. One draws blood from the other.
It only happens in about 40 pregnancies a year in Minnesota. Left untreated, it's fatal for twin fetuses about 90 percent of the time.
But this summer doctors used a tiny camera and a fiber optic laser to sever the tiny blood vessels between the two, some of them no thicker than a human hair. It's a first of its kind procedure in Minneapolis. Until now parents have had to travel to Ohio or beyond for the experimental surgery.
Doctors Brad Feltis and William Block did the surgery at Abbott Northwestern Hospital in Minneapolis, just days after the twins condition was diagnosed. Feltis said it's a challenging procedure.
"The babies are moving. They're tumbling around inside the amniotic sac, and they're frequently getting in our way, and we have to gently nudge them aside, but you adapt your technique. But yeah, it's a technically challenging surgery."
The two boys were born by C-section and weigh a little under five-and-a-half pounds. They appear to be a healthy pair of twins. Their parents, Jeane and Jeff Cassellius, of Roberts, Wis., showed them off at a press conference at Abbott Northwestern Hospital.
"It's absolutely amazing. They're miracle babies," said Jeane.
Her husband Jeff agreed. "It just feels good after everything you hear, that they might not make it," said Jeff. "You know, we had all the confidence in the world in the doctors and the hospital that it was going to be fine. But when you finally see them, you just say, 'Okay, we can breathe and everything, and everything's fine.' You're not worried anymore, but of course, you still are worried."
Doctors told the Cassellius' that nearly one in ten twins who survive the condition have neurological abnormalities of some kind.
The procedure itself has had mixed success in Minneapolis, where it has been performed about a half dozen times. Children's Hospital doctors didn't want to talk specifically about other cases or any failures they have had, but they said their results compare well with outcomes elsewhere. Even with the procedure, the odds of both twins surviving is less than 50-50. Doctors said at least one of the twins survives about 90% of the time.
More importantly, though, doctors say the procedure is a turning point. Most prenatal surgery has been done with ultrasound in the past, but this new procedure depends on live video. A tiny camera, just two millimeters wide, helped doctors see the twins, the placenta they shared and the tip of the laser that separated them, in real time.
Doctors hope the technology will become as useful for prenatal care as minimally invasive laparoscopic procedures have become for surgery on adults.
- All Things Considered, 10/24/2008, 4:46 p.m.