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Eur J Cardiothorac Surg 2000;17:201-205
© 2000 Elsevier Science NL
Cardiac Surgery Department, IRRCS Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy
Corresponding author. Tel.: +39-2-2643-7109; fax: +39-2-2643-7125
e-mail: francesco.maisano{at}hsr.it
Objectives: Mitral-valve repair in Barlow's disease is challenging; conventional techniques are difficult to perform, and there is a high risk of a postoperative suboptimal result. Double-orifice repair has been applied in a standardized approach to treat patients with severe mitral regurgitation and bileaflet prolapse due to Barlow's disease. Methods: Since 1993, 82 patients with severe mitral regurgitation due to Barlow's disease underwent correction applying the edge-to-edge concept. They were submitted to double-orifice repair in a standardized fashion, suturing the middle portions of both leaflets. Results: There were no hospital deaths. The repair was unsatisfactory in one patient who underwent valve replacement soon after the repair. The mean postoperative valve area was 3.7±0.79 cm2 against a mean preoperative value of 9.2±2.1 cm2. No or mild regurgitation was found in all but three patients who showed moderate residual regurgitation. There were no late deaths. Freedom from reoperation was 86±14% at 5 years. At the latest follow-up, all patient but one were New York Heart Association (NYHA) functional class I, and echo-Doppler assessment of valve reconstruction showed stable valve function in all patients. Conclusions: The double-orifice repair can be used as a standardized approach to treat valve regurgitation due to Barlow disease with low risk and good early and mid-term results.
Key Words: Mitral regurgitation • Valve repair • Barlow's disease • Mitral-valve prolapse
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