title: Repair of bileaflet prolapse in Barlow syndrome.
abstract: Mitral valve (MV) leaflet billowing, prolapse, and excessive tissue are hallmarks of Barlow syndrome. Successful MV repair can be a challenge in these oftentimes young and otherwise healthy patients. We herein present details on our stepwise approach to MV repair for Barlow syndrome including: (1) surgical approach; (2) MV exposure; (3) assessment of MV pathology; (4) repair of leaflet prolapse; (5) choice and sizing of annuloplasty ring; and (6) fine-tuning and troubleshooting. Our repair strategy involves extensive use of Gore-Tex neochordae using the so-called "loop technique." We have used this operative strategy via a right mini-thoracotomy in 436 patients with bileaflet prolapse and 144 patients with Barlow syndrome. Our successful MV repair rate is 95% in patients with Barlow syndrome and the ten-year freedom from reoperation rate is 96% for such patients. We can conclude that a stepwise approach to this MV pathology with extensive use of the loop technique can result in very acceptable outcomes, even in patients undergoing minimal invasive surgery.
authors.affiliation: Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany. michael.borger@med.uni-leipzig.de
authors.forename: Michael A
authors.initials: MA
authors.lastname: Borger
authors.forename: Friedrich W
authors.initials: FW
authors.lastname: Mohr
mesh_terms: D040181:Genetic Diseases, X-Linked / Q000175:diagnosis / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D008943:Mitral Valve / Q000002:abnormalities / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000295:instrumentation; D008945:Mitral Valve Prolapse / Q000175:diagnosis / Q000601:surgery; D011474:Prosthesis Design; D012086:Reoperation; D013536:Suture Techniques; D013908:Thoracotomy; D013997:Time Factors; D016896:Treatment Outcome