Surgeon Performs First Living Mitral Valve Replacement

An ACS Fellow recently performed a new and successful cardiac operation—the world’s first living mitral valve replacement, wherein an adolescent girl received a full heart transplant and then donated the healthy valves from her original heart.

Joseph Turek, MD, PhD, FACS, chief of pediatric cardiac surgery at Duke University School of Medicine in Durham, North Carolina, led the procedure alongside a large care team.

The current standard of pediatric heart valve replacement involves using either preserved non-living tissue or mechanical mitral valves, which do not grow with a child and thus require regular replacement surgeries throughout the developmental years. A mitral valve replacement is challenging in the best of circumstances, due to the valve’s location in the rear of the heart and unique shape that makes it difficult to suture.

Dr. Turek’s new technique is a type of “partial heart transplant” that provides healthy valves from a replaced heart to one or more recipients, which ideally will address both the issue of growth and subsequent additional valve replacement as well as provide a potentially multi-use resource to a strained organ transplant system.

In this case, an 11-year-old patient received a full heart transplant after sudden heart failure, and surgeons were able to use the remaining healthy mitral valve for a 14-year-old patient whose valve was failing due to endocarditis. In addition, a second healthy valve was able to be placed in a now 9-year-old patient who has Turner syndrome.

“To think that the lives of three girls could be saved after one full-heart donation is amazing,” Dr. Turek said.