Former US First Lady Barbara Bush is "alert" after open-heart surgery and is recovering at a hospital in Texas, a Bush family spokesman has said.
The 88-year-old wife of former President George HW Bush had the surgery after doctors found hardening on her heart's aortic valve.
The two-and-a-half hour operation was described as routine and she is expected to make a full recovery.
Barbara Bush underwent surgery last year for a perforated ulcer.
A spokesman for the former first lady said the operation had been scheduled as a precaution after doctors found hardening on one part of her aortic valve.
The doctors have now replaced the aortic valve with a biological valve and say the operation was successful.
Her husband is at her bedside and it is thought that she will stay in hospital for about a week.
A spokesman for the Bush family described Mrs Bush as "alert and funny" and she was said to be resting comfortably.