Robotic mitral valve plasty for mitral regurgitation after blunt chest trauma in Barlow's disease

Abstract

We successfully treated a case of mitral regurgitation due to chest trauma in Barlow's disease. A 71-year-old man was admitted with severe mitral regurgitation after blunt compression of the chest by a heavy object 5 months earlier. Preoperative examination revealed wide chordae tendineae rupture and myxomatous changes to the bileaflets. Neo-chordae reconstruction of the anterior mitral leaflet using loop technique, triangular resection of the posterior mitral leaflet, and ring annuloplasty was performed via surgical robot. Robotic mitral valve plasty for severe mitral regurgitation due to chest trauma in Barlow's disease was achieved safely with good clinical and excellent cosmetic results.

Outcomes of Barlow mitral valve repaired by robot-assisted keyhole surgery

“…The robotic 3-dimensional camera provided clear visuals and assisted with precise manipulation, measuring the distance from the papillary muscle to leaflet coaptation zone or the distance to annulus, and neochordae establishment was accomplished with ease. 2 , 10 …”

“…Mitral valve repair (MVr) for Barlow disease is considered to be complicated due to the mixed pathophysiology of the condition. 1 , 2 Since the regurgitations are consistent with multiple prolapsed lesions, including both anterior and posterior leaflets, every prolapsed or billowed segment should be corrected to achieve a clear mitral surface. In addition, owing to its redundant leaflet tissues, especially in the posterior leaflet, the risk of iatrogenic systolic anterior movement (SAM) is a serious consideration during surgical management.…”

ACR Appropriateness Criteria® Blunt Chest Trauma-Suspected Cardiac Injury

“…All valvular injuries present with signs and symptoms of regurgitation, therefore, it is prudent to perform echocardiography and assess the severity of regurgitation to guide further management with surgical repair in severe cases. Several case reports describe posttraumatic severe mitral regurgitation requiring surgical repair following MVAs [55][56][57].…”