DURHAM, N.C. A medical team at Duke Health has achieved a groundbreaking milestone by completing the first-ever living mitral valve transplant after performing a historic heart transplant. They also successfully performed a pioneering procedure, extracting healthy valves from an adolescent girl to benefit two other individuals. All the young recipients in this study hail from different regions across North Carolina.
The standard approach for pediatric heart valve replacement depends on non-living preserved tissue and mechanical tissue equivalents that do not adjust as children grow. These conventional replacement options require multiple surgeries in the future or lifelong utilization of blood thinners for mechanical valves, thus showing significant risks.
According to Dr. Douglas Overbey, an assistant professor in the surgery department at Duke University School of Medicine, there has never been a perfect solution for valve replacement among children. The available replacement options often fail over time, forcing patients into multiple subsequent surgeries. The conversation with families becomes challenging because re-operation may be necessary when their child grows since a new valve is needed due to size limitations.
Margaret Van Bruggen, a 14-year-old from Charlotte, became the first patient to receive a living mitral valve through a groundbreaking procedure when Journi Kelly from Wilson donated the valve at 11 years old. Through a full-heart transplant, Journi donated another valve that saved the life of 9-year-old Kensley Frizzell of Pembroke. Scientific evidence demonstrates that implants of living valves through this surgical method led to valve growth, representing a revolutionary advancement in treatment. Through Food and Drug Administration (FDA) oversight, the institution successfully performed 20 partial heart procedures.
Organ donation strategies are optimized because healthy heart valves can be reclaimed for use in other transplant patients. Through this method, organs deemed nonviable can transfer working valves to save multiple lives during domino heart transplant operations. Dr. Joseph Turek from Duke declared after his research that “saving three people from one heart donation remains an extraordinary achievement.”
The surgical procedure faced substantial obstacles because of both the complex nature of the mitral valve and its deep position inside the heart. The valve contains several muscles and chordae tendineae, which pose challenges during surgical implantation.
Journi required intensive medical attention after experiencing a sudden stomachache that prompted her parents to take her to the emergency room. The medical tests confirmed heart failure, so her doctors immediately sent her to Duke’s facilities while awaiting a donor heart transplant.
The medical staff at Journi’s hospital presented a new surgical option to Rachel Kelly and her family before performing the procedure and requested permission to use Journi’s heart valve for transplantation purposes. The medical team immediately received consent after they described how the donation could save other children. Journi’s original heart valves secured their position as suitable replacements for Margaret and Kensley when a donor’s heart became available. Margaret, who participated in high school cross-country races, also needed emergency valve replacement because a bacterial endocarditis infection led to severe damage in her mitral valve.
Elizabeth Van Bruggen stated, “Margaret was hospitalized and could have died before receiving treatment. She demonstrated remarkable bravery, which made me fight harder for both of us. Her future holds many valuable contributions that the world deserves to witness.”
The surgical replacement procedure can potentially prevent Kensley from requiring any future heart operations. During her first two months of life, doctors detected Turner’s syndrome and she needed two cardiac surgeries for her heart. Kensley’s father, Kenan Frizzell, expressed surprise about this new surgical possibility when he stated, “We knew she would need another operation but never expected this type of procedure.” Our family extends deep appreciation for the exceptional coordination that enabled this groundbreaking medical accomplishment. Research supporting this novel surgical method was made possible through two important grants from the Brett Boyer Foundation and the Graeme McDaniel Foundation.
References: Duke Health. Duke Health performs the world’s best living mitral valve replacement. Published February 27, 2025. Accessed March 4, 2025. https://corporate.dukehealth.org/news/duke-health-performs-worlds-first-living-mitral-valve-replacement
