When Bob Blake went to Duke Health for a kidney transplant evaluation, experts discovered blockages in his coronary arteries that put him at risk for a heart attack. Instead of traditional heart bypass surgery, Blake underwent minimally invasive coronary artery bypass grafting. After a quick recovery, Blake got his transplant. “We probably cut off months of delay that could have prevented him from being a kidney transplant candidate,” said Duke kidney transplant specialist Matthew Ellis, MD. “The sooner we get someone transplanted, the better they do.”
Duke Felt Like the Right Choice
In June 2024, Bob Blake of Randleman, NC was diagnosed with kidney failure at the age of 63. When his daughter Jessica Soulia, 36, found out her father needed a kidney transplant, she went into research mode. “Time and time again, Duke continued to rise to the top of every list I found,” Soulia said. “I knew that choosing the right place for his care was one of the most important decisions we could make, and Duke felt like the right choice from the beginning.” Soulia’s contributions didn’t stop there: she volunteered to donate one of her kidneys to her dad. Testing showed she was a match.
Kidney Transplant Evaluation Flags Heart Disease
Before proceeding with surgery, Blake had to undergo a battery of tests to ensure his body could handle a transplant. During a standard stress test to evaluate his heart, transplant nurse practitioner Loretta Phillips noticed a red flag. Additional testing showed significant coronary artery disease in two blood vessels supplying Blake’s heart. He would need heart surgery before continuing with the kidney transplant process.
“With the amount and location of his coronary artery blockages, Mr. Blake would have been at high risk for a heart attack during his transplant surgery,” said Dr. Ellis. “Also, his post-transplant heart risk would have been quite high.”
Minimally Invasive Heart Surgery Offers Faster Path to Transplant
Duke heart surgeon Brittany Zwischenberger, MD, joined Blake’s care team and determined he was a candidate for minimally invasive coronary artery bypass grafting to treat one of his blockages. The second blockage could be treated with medication. Compared to traditional coronary artery bypass grafting (also known as CABG or heart bypass surgery), this option has several advantages, including a shorter recovery and reduced risk of sternal infection, bleeding, and stroke.
“The only step between Mr. Blake and a kidney transplant was addressing the coronary disease because he already had a donor,” Dr. Zwischenberger said. “So, I felt responsible to get him there. With minimally invasive CABG, we could approach his surgery without stopping his heart, without putting him on the bypass machine, and without the risk of developing a sternal wound infection.”
In March 2025, Blake underwent the minimally invasive heart surgery. He was walking around the hospital unit within 24 hours, went home a few days later, and was back at work at two weeks post-op. “I have to look hard to be able to see the scar there now,” Blake said.
Through Kidney Transplantation and Beyond
In late July 2025, Blake received a new kidney from his daughter. “I was so conflicted, because as her father, I'm the one who’s supposed to be protecting her,” Blake said. “It took me a while to accept that she was making the decision to give me this incredible gift, and so I should accept it and appreciate it.”
Blake’s transplant surgery and recovery were routine. He attends regular follow-up appointments at Duke every few months, and he must take immunosuppression medications for the rest of his life, but Blake said it’s more than worth it. He is happy to be back to work as the general manager of dining services at Greensboro College. Ultimately, Blake said he is grateful to feel like himself again.
“Before my surgeries, if I was walking around a department store or using a push mower to trim the yard, I would have to sit down within 20 minutes. I would be physically exhausted, and sometimes I'd have to go take a nap,” Blake said. “Now that's not an issue.”
Dr. Zwischenberger said it’s rewarding to see how minimally invasive heart surgery can help people like Blake. “Mr. Blake came to us with failing kidneys, which we fixed. And along the way, we had the opportunity to fix an undiagnosed, unknown, undiscovered problem with his heart, without jeopardizing this incredible gift from his daughter,” Dr. Zwischenberger said. “It shows what we can do together -- we can give our patients treatment options that work for them.”
