Early and long-term outcomes of mitral valve repair for Barlow’s disease: a single-centre 16-year experience†

Tomšič, Anton; Hiemstra, Yasmine L.; Pas, Stéphanie van der; Putter, Hein; Versteegh, Michel I.M.; Brakel, Thomas J. van; Marsan, Nina Ajmone; Klautz, Robert J.M.; Palmen, Meindert

doi:10.1093/icvts/ivx423

Cited by 10 publications

(3 citation statements)

References 21 publications

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“…BD is a common etiology of degenerative MV disease, which often leads to significant MR . The characteristic echocardiographic finding of BD is a billowing valve with excessively thickened leaflets (>3 mm).…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional echocardiography of mitral Barlow's disease with infective endocarditis: Perforations or cleft‐like indentations?

Pang

Wang

Liu

et al. 2019

J of Clinical Ultrasound

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Barlow's disease is a complicated form of degenerative mitral valve (MV) disease. Infective endocarditis (IE) often occurs on the basis of primary heart diseases and may be combined with valve perforations. Cleft‐like indentations (CLIs) were suggested by Ring et al. in 2013. They are located at the inter‐scallop position and involve at least one‐half of the valve. Herein, we report a case of Barlow's disease combined with IE and CLIs, which was confirmed intra‐operatively and by histopathological examination. The CLIs were misdiagnosed by two‐dimensional transthoracic echocardiography as perforations, but rightly interpreted by preoperative three‐dimensional echocardiography. The possibility of CLIs should be considered in the evaluation of mitral regurgitation caused by myxomatous MV diseases.

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Section: Discussionmentioning

confidence: 99%

Three‐dimensional echocardiography of mitral Barlow's disease with infective endocarditis: Perforations or cleft‐like indentations?

Pang

Wang

Liu

et al. 2019

J of Clinical Ultrasound

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“…In recent years, mitral valve (MV) repair has become the mainstream management for mitral regurgitation (MR) even in patients with extended lesions, including Barlow's disease 1–4 . For extended and complex lesions, resecting leaflets, artificial neochordal reconstruction, or a combination of both have been reported as repair methods 1–4 . We have consistently reconstructed artificial chords using the loop technique for the prolapsed leaflets without resecting.…”

Section: Introductionmentioning

confidence: 99%

Loop technique for degenerative mitral regurgitation due to extended prolapse

Abe

Fujii

Morisaki

et al. 2021

Journal of Cardiac Surgery

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Purpose: Our study aims to examine the midterm outcomes of the loop technique for extended mitral valve (MV) prolapse patients.Methods: From October 2008 to August 2020, we performed MV repairs in 407 patients with severe mitral regurgitation (MR). Follow-up ranged in duration from 287 to 2899 days (median, 872 days). The prolapse extensiveness (p-score) was determined based on the ratio of prolapsing segment's areas to whole area. We divided the whole MV into 10 segments (A1, A2 medial, A2 lateral, A3, P1, P2 medial, P2 lateral, P3, AC, and PC). Patients were categorized into three groups according to the p-score: simple (0.1-0.2), intermediate (0.3-0.4), and extensive (0.5-0.9).Results: All patients underwent MV repair with the loop technique. The rates of freedom from significant (moderate to severe or severe) MR at 5 and 7 years after surgery were 91% and 91%, respectively. There were 252, 115, and 40 patients in simple group, intermediate group, and extensive group, respectively. The following were significantly increased in extended group: Barlow disease (23/40 patients, p < .001), the number of loops (p for trend < .0001), and the technique score (p for trend < .0001). The rates of freedom from significant MR at 7 years after surgery were 92% in simple group, 87% in intermediate group, and 94% in extended group, respectively (p = .995).Receiver-operating characteristic curves showed a postoperative mild MR with a sensitivity of 86% and a specificity of 68% for predicting significant MR recurrence.Conclusions: MV repair using the loop technique was useful even in groups with extended prolapse.

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“…Mitral valve (MV) repair for mitral regurgitation (MR) due to posterior leaflet (PL) prolapse is achieved nowadays with a great success rate and a good survival, similar, in certain subgroups, to that of the normal population 1 . Carpentier et al 2 defined the terms and put the principles which, with some modifications, are still followed by many surgeons.…”

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confidence: 99%