Barlow's Mitral Valve Disease: A Comparison of Neochordal (Loop) and Edge-To-Edge (Alfieri) Minimally Invasive Repair Techniques

Silva, Jaqueline G. da Rocha e; Spampinato, Ricardo; Misfeld, Martín; Pfanmüller, Bettina; Eifert, Sandra; Mohr, Friedrich W.; Borger, Michael A.

doi:10.1016/j.athoracsur.2015.05.097

Cited by 29 publications

(12 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on surgical technique advancement and improved surgical outcomes, the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for valvular heart disease have recommended more MV repair rather than replacement [10]. However, due to the higher recurrence and reoperation rate of Barlow's disease [11][12][13], MV repair in Barlow's disease remains the largest challenge even for an experienced cardiac surgeon [14].…”

Section: Discussionmentioning

confidence: 99%

Mid-term Clinical Outcomes of Totally Thoracoscopic Repair for Mitral Regurgitation in Barlow’s Disease

Zhang,

Cui,

Shen

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective This study aimed to confirm the safety and feasibility of totally thoracoscopic repair for mitral regurgitation (MR) in Barlow’s disease. Methods From June 2018 to December 2022, 21 consecutive Barlow's disease patients (aged 33 ± 12 years; 57.1% male) underwent totally thoracoscopic mitral valve (MV) repair with leaflets folding, multiple artificial chordae implantation and ring annuloplasty. The safety and feasibility of this technique was evaluated by its mid-term clinical outcomes. Results There was no operative death or complications. The mean cardiopulmonary bypass (CPB) time was 190 ± 41 (128–267) min, and the aortic cross-clamp time was 145 ± 32 (66–200) min. The average number of artificial chordae implantation was 2.9 ± 0.7 (1–4) pairs. During a mean follow-up time of 25.6 ± 15.2 (1–52) months, all patients showed persistent effective valve function with a mean transvalvular gradient of 1.995 ± 1.543 (1.0–6.0) mmHg and no significant MR (10 cases of mild MR) or systolic anterior motion (SAM). Conclusions Totally thoracoscopic repair was a safe, effective, and reproducible procedure with satisfied mid-term clinical outcomes for MR in Barlow’s disease. However, further randomized and long-term follow-up studies were warranted to determine its clinical effects.

show abstract

Section: Discussionmentioning

confidence: 99%

Mid-term Clinical Outcomes of Totally Thoracoscopic Repair for Mitral Regurgitation in Barlow’s Disease

Zhang,

Cui,

Shen

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Recently, robot-assisted mitral valvuloplasty (R-MVP) has made it possible to perform plastic surgery for complex mitral valve prolapse; however, to choose MICS in cases of Barlow’s disease is challenging [ 2 – 5 ]. In Barlow’s disease, the repair process is complicated, and a cardiac arrest time is extended, so valve replacement is more likely to be selected than plastic surgery [ 6 ]. In the complex procedure of repairing the mitral valve in Barlow’s disease, precise sizing of the mitral annulus ring and artificial chordae is crucial.…”

Section: Introductionmentioning

confidence: 99%

“…In the complex procedure of repairing the mitral valve in Barlow’s disease, precise sizing of the mitral annulus ring and artificial chordae is crucial. The loop technique by Mohr et al and the concept of “respect rather than resect” by Perier et al have been accepted in recent years [ 6 – 8 ]. The emphasis is on using an artificial ring and artificial chordae to repair the mitral valve physiologically, instead of using “resection and suture,” which has traditionally been the approach of skilled surgeons.…”

Section: Introductionmentioning

confidence: 99%

Transesophageal echocardiography in robot-assisted mitral valve repair for Barlow’s disease: usefulness for predicting artificial ring size and artificial chordae length using the loop technique

et al. 2020

View full text Add to dashboard Cite

Background: There is no fully recommended methodology for surgery for Barlow's disease. Various methods have been proposed. The aim of this study was to investigate the effectiveness of transesophageal echocardiography (TEE) measurements for selecting the optimal annuloplasty ring size and determining the length of artificial chordae in patients with Barlow's disease who underwent robot-assisted mitral valvuloplasty (R-MVP). Methods: Ten patients were included. Before R-MVP, the anesthesiologist used TEE to predict the optimal annuloplasty ring size and artificial chordae lengths that would reduce mitral regurgitation. The anesthesiolosist's predict ring size was not presented to the surgeon intraoperatively. Results: In 70% (7/10) of cases, the surgeon performed mitral valve repair in full match with the anesthesiologist's repair plan. Mitral regurgitation was controlled in 85% (6/7) of cases. In three cases, the predict annuloplasty ring size and artificial chordae length were not match between anesthesiologist and surgeon. After the operation, 90% (9/10) of patients had no residual mitral regurgitation. Conclusions: Anesthesiologist's TEE measurements were useful for selecting the optimal annuloplasty ring size and artificial chordae length during R-MVP. TEE can play an important role in robot-assisted, minimally invasive cardiac surgery for mitral regurgitation with extensive and complex prolapse, such as in Barlow's disease.

show abstract

“…This elegant and comprehensive historical review of Barlow and colleagues on the Barlow valve 8 is another call for attention to the importance of reviewing history to understand the present and imagine the future.…”

mentioning

confidence: 99%

“…This complexity influences outcomes, although experienced centers report freedom from reoperation for regurgitation of 85% to 90% at 10 years. 6 , 7 , 8 …”

mentioning

confidence: 99%

Commentary: The Barlow valve: Understanding disease and symmetry

Mestres

Piñón

2021

JTCVS Techniques

View full text Add to dashboard Cite

Barlow's Mitral Valve Disease: A Comparison of Neochordal (Loop) and Edge-To-Edge (Alfieri) Minimally Invasive Repair Techniques

Cited by 29 publications

References 26 publications

Mid-term Clinical Outcomes of Totally Thoracoscopic Repair for Mitral Regurgitation in Barlow’s Disease

Mid-term Clinical Outcomes of Totally Thoracoscopic Repair for Mitral Regurgitation in Barlow’s Disease

Transesophageal echocardiography in robot-assisted mitral valve repair for Barlow’s disease: usefulness for predicting artificial ring size and artificial chordae length using the loop technique

Commentary: The Barlow valve: Understanding disease and symmetry

Contact Info

Product

Resources

About