First Infant in U.S. Receives Cow Valve Transplant

A 13-month-old boy has become the first person in the United States to have a valve taken from a cow’s neck transplanted in his heart, officials said.

Ryan Doty has been breathing on his own since Thursday night and the prognosis looks good, said Dr. John Brown, the cardiothoracic surgeon who performed the transplantation May 4.

The procedure, performed at Riley Hospital for Children in Indianapolis, has not been approved in the United States, but the Food and Drug Administration permitted the surgery as a “compassionate case” because of Ryan’s critical condition.

“He was extremely ill and really wasn’t expected to live. This was the only thing that could save his life,” Brown, the director of heart transplantation surgery at the Indiana University medical centers, told the Evansville Courier & Press.

Ryan was in fair condition Monday in Riley’s intensive care unit.

He was born with only one heart valve instead of two. When he was 3 months old, he received a heart-valve transplant from an infant who had died. But that valve weakened and developed leaks, said Brown, who performed the initial transplantation.

Brown said there is always a critically short supply of donor infant valves, and they tend to fail in transplants. In addition, pig valves used for transplant in adult hearts are too large for infants.

A valve from a cow’s neck “is perfect” for transplanting into an infant’s heart, Brown said.

“It has all the qualities and properties that heart surgeons have been looking for a long time,” he told the newspaper. “It’s strong, it’s the right size, it has all the surrounding tissue you need to make the hookup to the heart, and it’s less likely to have complications.”

The use of cow neck valves in infants was approved in Europe a year ago, Brown said. So far 13 such transplants have been performed successfully in Switzerland and Italy.

Eventually, infants will outgrow the small valve and will need to receive a pig’s valve, Brown said.