THE family of a nine-year-old Leeds girl born with a rare heart defect have been told she needs a third life-saving operation.
Ruby Varley of Kippax was born with a large hole in her heart and a blocked pulmonary artery and underwent her first heart surgery at four-weeks-old and a second operation at 16 months.
Now surgeons at Leeds Children's Hospital have told Ruby's family she must undergo a third operation to replace the pulmonary artery, which she has outgrown.
Ruby, a pupil at Ashtree Primary School Kippax, will have to undergo surgery to replace the artery throughout her life.
Make-A-Wish UK made Ruby's dreams come true in June 2017 when they flew Ruby and her family to Switzerland to see Justin Bieber in concert and meet him backstage.
The moment Ruby met her hero was also caught on video.
Ruby's mother Natalie Varley, 40, said: He was lovely, he was really kind. He signed some stuff for her and took selfies with her and gave her a kiss on the cheek.
"Ruby is a massive Justin Bieber fan and can't wait for his new album to come out.
"We still talk about the trip to Switzerland to see him. They are nice memories for Ruby.
"When she goes into hospital they will be the things when she is upset that we will talk about as a distraction."
Mrs Varley said: "Ruby gets tired easily and struggles with activity because she has outgrown the pulmonary artery they made for her and put in during the second operation.
"We were expecting it (the third operation) because she has been tired for a while now and we just want to get on with it."
Ruby was due to go on holiday to Spain later this month with mum Natalie, dad Alex, 39, and her five-year-old brother Ethan.
But the family has had to cancel the holiday.
Mrs Varley said: "We have put our lives on hold for a while now so it will be good to get it over and done with.
"Once we have had the surgery meeting in the next few weeks she will go on the waiting list and then it will be a maximum of 18 weeks until she has the surgery."
"Hopefully things will go back to normal and hopefully she will recover well and we can start living life again.
"She takes it all in her stride She knows she is having an operation and she knows it's got to be done.
"She is a happy kid, nothing fazes her. I think it bothers me and her dad more than it bothers her."
Mum is volunteer for Make-A-Wish UK
The Varley family staged a fundraising event for Make-A-Wish UK after Ruby met her hero Justin Bieber.
They held a family fundraising evening at Garforth Working Men's Club, which raised £3,500 for the charity.
Ruby's mother Natalie is volunteer for Make-A-Wish UK and has carried out public speaking engagements at events to raise awareness of the charity's work.
The Make-A-Wish UK website states: "Together, we create life-changing wishes for children with critical illnesses.
"Whether it's starring in their own films, walking with dinosaurs, going on an amazing holiday, meeting a celebrity hero, or having a bedroom makeover; our wishes are varied, personal and life-changing.
"We go above and beyond to grant amazing wishes to very amazing children; their One True Wish made a reality at a time when they need it most.
"Because a child's life shouldn't be about illness, hospitals and diagnosis - it should be about wonder, joy and hope.
"We've seen the effects a wish can have on a seriously ill child: from creating incredible memories, building confidence and bringing happiness, to providing respite from the daily struggles that come with a critical illness. We know what wishes can give, and this is the driving force behind why we continue to do what we do.
For more information, go to www.make-a-wish.org.uk/