Health
New Jersey twins receive matching heart surgeries after Marfan syndrome diagnosis: 'A better life'
The notion that twins do everything together has met a new standard.
Identical twin brothers Pablo and Julio Delcid, 21, underwent matching heart surgeries on the exact same day following their diagnosis of Marfan syndrome.
The duo, of Dover, New Jersey, had been alerted to their risk of Marfan syndrome because a majority of their family members also have it, the twins told Fox News Digital in an on-camera interview.
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“We’re a family of five. I have two older sisters who have it,” Julio Delcid said. “My older brother doesn’t have it as much … But I also have other family members who have it, too — pretty much through my whole family on my mom’s side.”
Left to right, Pablo Delcid and Julio Delcid celebrate Christmas with some of their family members. (Pablo and Julio Delcid)
“It’s very genetic,” Pablo Delcid added. “When we were younger and were first diagnosed with it, nobody knew what it was.”
He added, “Nobody knew they even had it until tests kept coming in, and they were like, ‘Yeah, it’s pretty genetic. Everyone should get tested.’”
What is Marfan syndrome?
Fox News Digital spoke with Dr. Benjamin Van Boxtel, surgical director at the Atlantic Aortic Center at Morristown Medical Center, in a separate interview about the condition; he performed the twins’ surgeries.
The cardiovascular surgeon said that while Marfan syndrome is mostly genetic, it can also occur at random. It’s a defect of the gene that creates connective tissues in the human body, he said.
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“Because it’s a broad defect in these connective tissues, it can affect many different parts of the body,” he said. “So, this could be anywhere from the eyes to the spine and … the heart.”
“The most dangerous symptom you could develop with Marfan syndrome is a dilation of the aorta, specifically in the root,” he added.
Van Boxtel said the aortic root in Marfan syndrome can become dilated or enlarged, which can cause an “immediately fatal” tear or rupture.
Van Boxtel holds up a “tube-shaped graft” model used during a valve sparing root operation, in which the surgeon “replaces the aortic root and then hand-sews leaflet by leaflet inside that graft.” (Angelica Stabile/Fox News Digital)
“Or it can cause something called an aortic dissection, which is also potentially very fatal, and becomes a surgical emergency,” he said. “That’s unfortunately how a lot of people who have Marfan syndrome pass away.”
Many of those people don’t even know they have the syndrome, Van Boxtel noted.
A valve-sparing root procedure performed before a dilated aorta dissects can be a life-saving operation.
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Marfan syndrome can be difficult to spot, according to Van Boxtel, as it’s often marked by common symptoms such as chest pain, poor vision — or being tall and having long limbs.
“When you have an aneurysm [from a] dilated aorta, it’s generally asymptomatic, meaning you feel absolutely nothing,” he said. “You feel completely fine … Aneurysm disease is silent, it’s asymptomatic — which can be really dangerous.”
Left to right, Julio Delcid, the twins’ mother, Betulia Miranda, and Pablo Delcid snap a selfie. (Pablo and Julio Delcid)
Pablo Delcid, for his part, said there’s “not much you can feel when you’re growing into the condition.”
He added, “What we didn’t know was that our bodies were changing … obviously with height, vision, the length of our arms, feet, legs, even with our chest.”
Surgery on the same day
The twins’ mother, Betulia Miranda, had an emergency procedure on Oct. 8, 2023, after experiencing an aortic dissection, which the boys described as “excruciating” for her.
After their mother’s surgery was a success, the twins decided to seek preventative surgery performed by Dr. Van Boxtel – but their one request was that they do it together.
“Of course they’re like, ‘Can we go at the same time?’” the doctor said with a laugh.
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Van Boxtel, a father of twins himself, said the double surgery was like “nothing I’ve ever done before.”
He said, “I’ve done this procedure hundreds of times. But to do it back-to-back on twin brothers — it was an experience, that’s for sure.”
It was decided that Pablo Delcid would go first, since he was born five minutes before his brother, followed by Julio Delcid several hours later.
Julio Delcid, left, and Pablo Delcid underwent heart surgery on Jan. 5, 2024. (Pablo and Julio Delcid)
“We always do everything together,” Pablo Delcid said. “We live together, go through everything together … We didn’t think we could get the operation done together, but everything [was] successful.”
The twins agreed that they felt “safer” knowing they were going through the procedure together.
“You kind of feel like you’re not going to lose that person,” Julio Delcid said. “They’re sticking with you, side by side.”
“Aneurysm disease is silent, it’s asymptomatic — which can be really dangerous.”
Pablo Delcid added, “It’s like your gut’s telling you, ‘All right, if I make it, he’s going to make it.’”
On surgery day, Jan. 5, 2024, Van Boxtel and his team distinguished the twins from one another using color-coded ankle bracelets.
The surgeon emphasized the rarity of double heart surgery on twins, especially at such a young age of 21. “This is like the ultimate twin study,” he said.
Van Boxtel said it was “freaky” when he realized that the brothers’ hearts were also identical.
“I knew they could be different on the inside, but it ended up that they were the exact same,” he said.
Julio Delcid said he was “shocked” that a surgeon like Van Boxtel could take on both surgeries back to back.
“He did the best he could,” he said. “He successfully saved our aortic valves, replacing the aneurysm … We were very appreciative.”
More about Marfan
Marfan syndrome affects about one in 5,000 people, according to Van Boxtel, and impacts men and women equally.
“About 75% of those cases are genetic,” he said. “But about 25% of Marfan cases are actually not inherited. They’re not from a parent. They’re a spontaneous mutation.”
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Along with a dilated aortic root (enlarged aorta) or narrow dissection (tear in an artery), patients also run the risk of having a leaky valve, which can lead to heart failure symptoms like shortness of breath, chest pain, dizziness and inability to perform normal exertional activity, Van Boxtel said.
Since Marfan syndrome is often hard to spot on the surface, the Delcid twins emphasized the importance of getting tested, especially for those within the Latin and Hispanic communities.
Julio Delcid said that those at risk of Marfan syndrome should “take the time to get yourself checked out.” (Pablo and Julio Delcid)
“It’s pretty lethal,” Pablo Delcid said. “We almost lost our mother, and that was a traumatic experience.”
People with symptoms or with a family history of Marfan syndrome should educate themselves on how best to prevent an aneurysm and connect with a cardiology team, Julio Delcid reiterated.
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“It’s just very important to take the time and the opportunity to get the best treatment that they could possibly get, because if they wait, consequences will happen later,” he said.
“Don’t fear anything. Just take the time to get yourself checked out and get the help that you need to live a better life.”
Looking ahead with new hope
With the stresses of heart surgery behind them, the twins said they’re looking forward to getting outside, playing sports and exercising more than they could before.
“Both their valves were saved,” Van Boxtel said. “They weren’t leaking at the end. All the things that we look for in a very successful repair they had, and they’re going to go on and live normal, healthy lives.”
“It’s a very serious problem … but there’s prevention available, and if you get it at the right time, it can be very successful.”
He said he hoped that “these valves last a really, really long time, if not the rest of their lives. They’re much better off now than they were walking around with aneurysms.”
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Van Boxtel thanked his team for handling the complex, same-day operations on young men with their “whole lives ahead of them.”
Dr. Benjamin Van Boxtel is a cardiovascular surgeon and the surgical director of the Atlantic Aortic Center at Morristown Medical Center. (Atlantic Health System)
The Marfan Foundation has various resources for patients at all stages of the condition, the doctor noted.
“I can’t underscore how important it is for patients with aneurysms to be seen by a surgeon or a team who is comfortable performing that,” he said.
“It’s a very, very serious problem … but there’s prevention available, and if you get it at the right time, it can be very successful.”
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Cases of gout are rising in younger individuals, according to a global study.
The condition, which is a type of inflammatory arthritis, steadily increased in people aged 15 to 39 between 1990 and 2021, researchers in China announced.
Although rates vary widely between countries, the total number of young people with the condition is expected to continue rising through 2035.
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The study, published in the journal Joint Bone Spine, investigated 2021 data from the Global Burden of Disease (GBD), spanning 204 countries within the 30-year timeframe.
The data measured gout prevalence, incidence and years lived with disability, tracking global trends over time. The results showed a global increase across all three outcomes.
Gout is expected to continue rising in young people through 2035. (iStock)
Prevalence and disability years increased by 66%, and incidence rose by 62%. In 2021, 15- to 39-year-olds accounted for nearly 14% of new gout cases globally, the study found.
Men from 35 to 39 years old and people in high-income regions had the highest burden, but high-income North America topped the list for highest rates.
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Men were also found to have lived more years with gout due to high BMI, while women tended to have the condition as a link to kidney dysfunction, the study noted.
The total number of cases is expected to increase globally due to population growth, but the study projected that rates per population would decrease.
The researchers noted that data quality, especially in low-income settings, could have posed a limitation to the broad GBD data.
What is gout?
Gout is a common form of arthritis involving sudden and severe attacks of pain, swelling, redness and tenderness in the joints, according to Mayo Clinic. It most often occurs in the big toe.
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The condition occurs when urate crystals accumulate in the joint. These form when there are high levels of uric acid in the blood, which the body produces when it breaks down a natural substance called purines.
A gout flare-up can happen at any time, often at night, causing the affected joint to feel hot, swollen, tender and sensitive to the touch.
Urate crystals, described as sharp and needle-like, build up in the joint, causing intense pain and swelling. (iStock)
Purines can also be found in certain foods, like red meat or organ meats like liver and some seafood, including anchovies, sardines, mussels, scallops, trout and tuna, according to the Mayo Clinic. Alcoholic drinks, especially beer, and drinks sweetened with fruit sugar can also lead to higher uric acid levels.
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Uric acid will typically dissolve in the blood and pass through the kidneys into urine, but when the body produces too much or too little uric acid, it can cause a build-up of urate crystals. These are described by the Mayo Clinic as sharp and needle-like, causing pain, inflammation and swelling in the joint or surrounding tissue.
Risk factors for gout include a diet rich in high-purine foods and being overweight, which causes the body to produce more uric acid and the kidneys to have trouble eliminating it.
Experts urge patients to seek medical attention for gout flare-ups. (iStock)
Certain conditions like untreated high blood pressure, diabetes, obesity, metabolic syndrome and heart and kidney diseases can increase the risk of gout, as well as certain medications.
A family history of gout can also increase risk. Men are more likely to develop the condition, as women tend to have lower uric acid levels, although symptoms generally develop after menopause.
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Untreated gout can cause worsening pain and joint damage, experts caution. It may also lead to more severe conditions, such as recurrent gout, advanced gout and kidney stones.
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The Mayo Clinic advises patients to seek immediate medical care if a fever occurs or if a joint becomes hot and inflamed, which is a sign of infection. Certain anti-inflammatory medications can help treat gout flares and complications.
Fox News Digital reached out to the researchers for comment.
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A new study suggests that annual mammograms may not be the only effective approach for preventing breast cancer.
The research, published in the Journal of the American Medical Association (JAMA), tested a risk-based breast cancer screening approach against standard annual mammography.
The WISDOM randomized clinical trial, led by study authors from universities and healthcare systems across the U.S., considered more than 28,000 women aged 40 to 74 years old, splitting them into a risk-based screening group and an annual mammography group.
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Researchers calculated each woman’s individual risk based on genetics (sequencing of nine breast cancer genes) and other health factors.
A new study suggests that annual mammograms may not be the only effective approach for preventing breast cancer. (iStock)
Those who were at the highest risk were advised to alternate between a mammogram and an MRI scan every six months. Patients with elevated risk were told to get an annual mammography and counseling.
Average-risk women were guided to get mammograms every two years, while low-risk individuals were advised to have no screening until they became higher risk or reached age 50.
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The researchers found that risk-based screening did not lead to more advanced cancer diagnoses (stage 2B or higher) compared with annual screening, indicating that it is just as safe as traditional methods. The risk-based approach, however, did not reduce the number of biopsies overall, as researchers had hoped.
Among the risk-based group of women, those with higher risk had more screening, biopsies and detected cancers. Women at lower risk had fewer procedures.
The research, published in the Journal of the American Medical Association (JAMA), tested a risk-based breast cancer screening approach against standard annual mammography. (iStock)
“[The] findings suggest that risk-based breast cancer screening is a safe alternative to annual screening for women aged 40 to 74 years,” the researchers noted in the research summary. “Screening intensity matched individual risk, potentially reducing unnecessary imaging.”
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Fox News medical contributor Dr. Nicole Saphier, associate professor of radiology at Memorial Sloan Kettering Cancer Center in New Jersey, commented that while these findings are important, the study “completely sidelines” what screenings are designed to do — detect cancer early.
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“If you don’t measure stage 0, stage 1 or stage 2A cancers, you can’t tell whether personalized screening delays diagnosis in a way that matters for survival and treatment intensity,” Saphier, who was not involved in the study, told Fox News Digital in an interview.
Those who were at the highest risk were advised to alternate between a mammogram and an MRI scan every six months. (iStock)
More than 60% of breast cancers in the U.S. are diagnosed at stage 1 or 2A, where cure rates exceed 90%, the doctor noted.
The trial doesn’t “fully evaluate” whether risk-based screening changes detection at the earliest and most treatable stages, where screening “delivers its greatest benefit,” according to Saphier.
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“Mammography is not without risk — radiation exposure, false positives, anxiety and potential over-diagnosis are real and should be acknowledged,” she said. “But it remains the most effective, evidence-based tool for detecting breast cancer early, when treatment is most successful.”
The expert added that labeling women under 50 as “low risk” is “outdated,” as breast cancer diagnoses are on the rise in younger females.
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“Until long-term mortality data support alternative approaches, annual screening beginning at 40 for average risk women should continue,” Saphier added. “Women should be assessed for breast cancer risk by 25 years old to determine if screening should begin earlier.”
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