Duke doctors perform the first mitral valve transplant in life

The procedure was made possible after 11-year-old Journi Kelly of Wilson, North Carolina, received a whole heart transplant at Duke.

Instead of getting rid of her original heart, doctors salvaged two healthy valves and transplanted them into two other children.

One valve went to 14-year-old Margaret Van Bruggen, a cross-country runner from Charlotte, North Carolina, who was in dire need of a mitral valve replacement after a severe bacterial infection.

The other valve went to Kensley Frizzell, 9, of Pembroke, North Carolina, who was born with a genetic condition called Turner syndrome that can cause heart defects. He had already endured multiple heart surgeries.

Currently, children who need heart valve replacements receive preserved nonliving tissue or mechanical valves, which do not grow with the child and often fail within months.

"There's no good valve option for kids," said Dr. Douglas Overbey, an assistant professor of surgery at Duke University School of Medicine in Durham, N.C.

"They all require multiple surgeries, and we know they're going to fail in the future," Overbey added in a news release. "That's something that's very difficult to talk to parents about, to know that you're going to have to do the same surgery with a new valve, maybe six months later because they're going to get through it."

Duke's new method, called partial heart transplantation, uses live valves from donated hearts, providing children with valves that can grow with them, which could reduce the need for future surgeries.

Since pioneering the technique in 2022, Duke has performed 20 partial heart transplants under the guidance of the U.S. Food and Drug Administration (FDA).

Journi's journey began when she was rushed to Duke after sudden heart failure.

She was placed on the transplant list and her parents were asked if they would consider donating parts of her old heart after her transplant.

"They explained to us that they could use the healthy parts to help other children. Our next question was, 'Where do we sign?' Rachel Kelly, Journi's stepmother, said.

When a donated heart became available to Journi, it was discovered that his original valves were perfectly compatible for Margaret and Kensley.

For Margaret, the valve transplant came just in time.

After developing a serious bacterial infection called endocarditis, large holes formed in his mitral valve, and his health began to deteriorate rapidly.

"She was in the hospital, and we could have lost her," Margaret's mother, Elizabeth Van Bruggen, said in a news release. "But she was very brave, so I knew I had to be brave too. There is a lot left to give to the world."

For Kensley, whose heart condition has been linked to Turner syndrome, the transplant could mean the end of a long series of heart surgeries.

"We expected him to need surgery, but we never knew this would be an option," said his father, Kenan Frizzell. "The whole situation is extraordinary, whether you look at it from the point of view of a scientific breakthrough or from the point of view of an average person. I can't imagine all the coordination it takes to make something like this happen, but as one of the families that benefited, we can only be grateful."