Two-year-old conjoined twin sisters Heloísa and Helena Batista da Silva died on the operating table during their fifth surgery intended to separate them. The tragic event occurred on August 15 at the Hospital das Clínicas in Ribeirão Preto, Brazil.
The toddlers were born with their heads fused, sharing brain tissue and blood vessels. They had undergone four previous surgeries to gradually separate these shared elements. The fifth procedure on August 15 was planned as the final separation surgery.
Over 50 medical staff were involved in the complex operation. Shortly after the twins were separated, their conditions rapidly deteriorated. The medical team reported that the girls experienced hemodynamic instability, a condition where insufficient blood flow to vital organs can lead to failure and death.
One twin developed high blood pressure, while the other experienced low blood pressure. Helena suffered a heart attack at 11:12 p.m. and Heloísa had one at 11:26 p.m. Despite 25 minutes of resuscitation efforts, Helena passed away at 11:37 p.m. and Heloísa at 11:51 p.m.
Jayme Farina Júnior, a plastic surgeon on the medical team, stated that the twins had fragile bodies and had been frequently ill throughout their short lives, suffering from pneumonia and requiring medical interventions such as a tracheostomy and gastrostomy for feeding. He explained that their bodies ultimately could not withstand the instability following the final separation, leading to cardiac arrest.
Earlier surgeries had successfully separated approximately 75 percent of their shared blood vessels and brain tissue. A fourth procedure involved the placement of tissue expanders to prepare sufficient skin for closing their skulls.
The twins were buried on August 16 in São José dos Campos. Their father, Amarildo Batista da Silva, expressed gratitude to the medical staff, stating he did not blame them for the outcome and acknowledged their many victories in saving children.
Heloísa and Helena were the third set of craniopagus twins, joined at the head, to be treated at the Hospital das Clínicas. Their medical treatments were funded by Brazil's public healthcare system.