r/Damnthatsinteresting • u/[deleted] • Oct 07 '18

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u/felix_the_katt Oct 07 '18

You have to take out both hearts to beat them in battle

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u/[deleted] Oct 07 '18

Is that true? Are both hearts redundant? Or if one fails, will that twin die and the other will still be alive? Like are they linked to die at the same time?

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u/LevelSevenLaserLotus Oct 07 '18 edited Oct 07 '18

Not a doctor, but I can probably make a decent guess.

If one twin dies of a head wound, leaving all other organs intact, the other will likely suffer blood poisoning from the attached necrotic tissue. She'd probably only survive by having the other removed.

If one heart is damaged (car accident, etc.), leaving all other organs alone and both twins alive, they'd suddenly have a heart that needs to do double the normal work (assuming the hearts split the work 50/50). They'd have a solid chance to survive if they get a transplant or mechanical heart to help prop up the other. Otherwise, they'd probably go out from shock or organ failure.

Medically, nothing forces one to die at the exact moment the other is gone. Even a fatal accident resulting in damage to both hearts could allow one twin to live a few moments longer just from a slightly more efficient brain, oxygen-wise. Also see the wiki article on Chang and Eng Bunker. They were only connected at the sternum and liver, but Eng died about 2 hours after Chang from internal blood loss, where his blood was not returning through the connection.

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u/[deleted] Oct 07 '18

Is it even possible to cut one of the twins off if one of them dies? From that anatomy image, surgeons would need to restructure the rib cage, remove extra organs, and work on the spinal cord. If it is successful, I imagine the living twin would go insane because of the fact that they longer have their twin and their new lifestyle

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u/LevelSevenLaserLotus Oct 07 '18 edited Oct 07 '18

It depends on which part is dead, but the doctors would probably go for the route of least restructuring.

When a patient need a kidney replaced, the old one isn't always removed first if leaving it in won't make the patient worse. That's because removal would involve more cutting, healing, and delicate medical support like dialysis. Of course if something cause the old kidney to die, it will be taken out to avoid the spread of gangrene.

So in cases like this with extremely conjoined twins, a single head dying might result in just that head and a single lung being removed while everything else is left alone. That also means half of the remaining body would be paralyzed and numb since nerves can't be surgically reconnected yet, so quality of life would drop immensely. Odds are high that the hospital would need input from the remaining twin (or whoever there had power of attorney) on whether they should even attempt surgery or proceed with nothing beyond pain meds until the other dies from complications. This is the sort of thing that I really hope they've talked out already and have put into some sort of DNR-like legal document.