Conjoined twin sisters have died just minutes apart while enduring a gruelling 15-hour operation to separate them.
Heloísa and Helena Batista da Silva, from Roraima, Brazil, were born craniopagus, meaning twins joined at the head, sharing brain tissue and blood vessels.
It’s a rare form of conjoined twin, happening one in every 2.5 million live births worldwide.
A vast majority are born still or pass away within 24 hours of birth.
Currently, survival rates for separating twins with the condition are at 50 to 60 per cent for at least one twin.
For the last two years the girls been monitored by a medical team at a hospital in Brazil.
The two-year-old sisters had completed four successful surgeries over the last year, with this fifth and final procedure hoped to have been their final separation.
The girls were the third set of craniopagus twins to have been treated at the hospital.
More than 50 medical and support staff were involved, working tirelessly toward their desired outcome.
Only minutes, after the girls were separated their condition took a turn and rapidly deteriorated.
Suddenly the youngsters began to suffer haemodynamic instability, or insufficient blood flow to vital organs, which can result in multiple organ failure and death.
During the operation one of the twins developed low pressure, while the other had high blood pressure.
Tragically, both of the girls died as the result of a heart attack just 14 minutes apart.
Doctors fought to save their lives, working to resuscitate them for 25 minutes before sadly pronouncing them both dead.
A plastic surgeon on the girls’ medical team explained both of the twins had experienced sickness for most of their lives and their bodies were weakened.
“They had many bouts of pneumonia, they had a tracheostomy, they needed a gastrostomy for feeding, and they had episodes that also weakened their bodies,” said Jayme Farina Júnior, a plastic surgeon on the team.
“But at the moment of the final separation, their bodies could not withstand this instability, and then they progressed to cardiac arrest.”
During the first three surgeries 75 per cent of the twins’ shared brain tissue and blood vessels were successfully separated.
While their fourth saw doctors use tissue expanders so that they could increase the amount of skin needed for closing their skulls ahead of the final separation operation.
The nation’s public healthcare system fully funded all of their treatments, with zero cost to their family.
The sisters were laid to rest the day following their surgery, nearby the family home.
Father, Amarildo Batista da Silva, extended his thanks to the doctors and hospital staff who tried their best to save his daughters.
He said he doesn’t blame them for the heartbreaking outcome.
“Every child you lose is a defeat, every child you manage to save is a victory,” the father said.
“I am sure you have far more victories than defeats, so this does not become a defeat.”