Mitral Valve Replacement Spares Woman from Heart Transplant

Severely weakened by three failed heart surgeries, all within one year, an Oklahoma woman thought her only option was a transplant—until her family called Baylor St. Luke’s Medical Center, clinical home of The Texas Heart Institute.

The next day, Ruirui Johnson and her family drove nine hours to the Houston hospital. Her heart was failing. She could not walk, and her shortness of breath made it difficult to speak. She was also extremely fatigued and constantly coughing due to fluid buildup in her lungs. It kept her from holding her 11-month-old daughter.

During her pregnancy, the 45-year-old piano teacher experienced swelling in her legs, feet, and face, which worsened after childbirth due to a mitral valve prolapse that kept blood from pumping to the rest of her body. Instead, it flowed back into her heart. While in Oklahoma, doctors attempted to repair the valve three times with no success. They told her she needed a new heart to survive.

World-renowned Cardiothoracic Surgeon Kenneth Liao was not convinced that a transplant was the best course of action, especially since heart transplant patients have a limited life expectancy of 11 years.

Liao, professor and chief of cardiothoracic transplantation and circulatory support at Baylor College of Medicine and chief of cardiothoracic transplantation and mechanical circulatory support at Baylor St. Luke’s, was out of the country lecturing on the use of robotic technology to perform mitral valve repair. He has performed over 500 robotic heart surgeries. After speaking by phone with the cardiac team, he was confident that “with the robot and our experience, our team could get it done.” 

"Dr. Liao told me, 'Wait for me. I don't think you need a heart transplant. You need to live longer than 10 years for your baby. I can fix this,’ ” Ruirui recalled.

Liao returned days later to replace the faulty valve. But this time, rather than performing another open-heart surgery, he used robotic technology, accessing the heart via a small incision beneath her right breast. 

Liao frequently publishes on heart surgery. As part of his research, his team compared the robotic mitral valve replacement surgery to the open-heart surgery approach. “The robotic approach has a significant advantage, including less blood loss, lower mortality rates, and shorter ICU stays,” he said.

Following her successful mitral valve redo, Ruirui was sedated in the ICU for a few days to allow her lungs to adjust. “But on day 5, I woke up and I felt much better. I could breathe, no coughing, and the swelling was getting better,” she recalled. 

She went home within two weeks of surgery.  Liao says her prognosis is good.  “If she takes blood-thinning medication appropriately, she can have a long-lasting life expectancy.”

Today, Ruirui is back home in Oklahoma, teaching piano lessons and caring for little Jacqueline. Jackie turned one year old at a birthday party that was both memorable and meaningful.

“Everything feels good,” Ruirui said. “Can you believe I survived?!  I cannot thank Dr. Liao enough. He didn’t want to do a heart transplant because he knew I needed to live a long life to be with my daughter. And now I will.”