NEW YORK — A day after their riskiest operation yet, two Filipino brothers joined at the tops of their heads greeted doctors with high-fives and a little dance Saturday.
Surgeons at Montefiore Medical Center said the 22-month-old brothers' liveliness following Friday's surgery was a sign they are still on course for surgery to fully separate them later this year.
"It's just incredibly moving to see that after this tremendous and delicate operation they're up and breathing on their own," said Dr. David Staffenberg after looking in on Carl and Clarence Aguirre.
The 5 1/2-hour surgery — the boys' third major operation — was treacherous and included such challenges as having to separate bone from blood vessels and trying not to damage delicate veins.
Staffenberg, Montefiore's chief of pediatric neurosurgery, said Carl performed a "wiggle dance" and Clarence offered his "usual shtick," which Dr. James Goodrich, the lead neurosurgeon, said included a high-five.
Doctors said it would be 72 hours before the main threat of bleeding and seizures passed.
Still, the doctors seemed relieved to have completed the tricky operation, during which one major shared vein and some smaller ones were divided. Had the major vein been punctured, the boys could have bled to death in minutes, Goodrich said.
Goodrich, holding a clear plastic model of the boys' heads showing the tangle of shared blood vessels, said most of the veins went to Clarence, who had a better circulation system to start with.
The hope is that Carl's other veins will take up the chore of draining blood from the brain, as they did after the first two operations in October and November.
"This is an area where when things go badly they go very, very badly and when things go well they go extremely well," Staffenberg said.
In each of the three operations, a different window of bone has been cut into the boys' shared skull, then replaced. Goodrich said just 2 inches to 3 inches remain to complete the circle that will separate the boys.