In advanced series of operations, surgeons at Duke Health have successfully performed the world’s first living mitral valve transplant, giving three young girls in North Carolina a new chance at life.
The pioneering procedure was made possible when 11-year-old Journi Kelly, from Wilson, N.C., received a full heart transplant at Duke. Instead of discarding her original heart, doctors preserved its two healthy valves and transplanted them into two other children in need.
One of the valves was given to 14-year-old Margaret Van Bruggen, a cross-country runner from Charlotte, N.C., who desperately needed a mitral valve replacement after a severe bacterial infection damaged her heart. The second valve went to 9-year-old Kensley Frizzell from Pembroke, N.C., who was born with Turner’s syndrome, a genetic condition that can lead to heart defects. Kensley had already undergone multiple heart surgeries.
Currently, children who require heart valve replacements are limited to either mechanical valves or preserved non-living tissue, both of which fail to grow with them and often require frequent replacements.
“There really aren’t good valve options for kids,” explained Dr. Douglas Overbey, assistant professor of surgery at Duke University School of Medicine. “Every option available today eventually fails, meaning children must endure repeated surgeries. It’s heartbreaking to tell parents that their child will need the same major operation again in just a few months.”
Duke’s innovative technique, known as a partial heart transplant, involves using living valves from donor hearts, which can grow with the child and potentially eliminate the need for repeated surgeries. Since first developing this approach in 2022, Duke has performed 20 partial heart transplants under U.S. Food and Drug Administration (FDA) guidance.
Journi’s medical journey took a critical turn when she was rushed to Duke after experiencing sudden heart failure. Once she was placed on the transplant list, her parents were given the option of donating parts of her original heart to help other children.
“They told us that her healthy valves could be used to save other kids,” said Rachel Kelly, Journi’s stepmother. “Our response was immediate: ‘Where do we sign?’”
When a donor heart became available for Journi, doctors determined that her mitral and aortic valves were a perfect match for Margaret and Kensley.
Margaret’s situation was especially urgent. She had developed endocarditis, a life-threatening bacterial infection that created large holes in her mitral valve, causing her health to deteriorate rapidly.
“She was in the hospital, and we came close to losing her,” recalled her mother, Elizabeth Van Bruggen. “But Margaret was so strong, and I knew I had to be strong for her. She has so much more to give to this world.”
For Kensley, whose heart problems stemmed from Turner’s syndrome, the transplant offered hope for a future without ongoing heart surgeries.
“We knew she would need another operation, but we never imagined something like this would be possible,” said her father, Kenan Frizzell. “This entire experience is incredible, whether you look at it as a medical breakthrough or from an everyday person’s perspective. The level of coordination and expertise required is beyond words, but as one of the families who benefited, we are endlessly grateful.”
