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Respect or resect in Barlow disease.
  • Gilles Dreyfus,
  • Filip Dulguerov
Gilles Dreyfus
Institut Mutualiste Montsouris
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Filip Dulguerov
CHUV
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Abstract

Mitral regurgitation in Barlow disease may still be challenging to be repaired . Most often it involves the posterior leaflet . Many techniques and concepts are currently available ; the main goal being to restore a good surface of coaptation . Basic principles such a thorough analysis is still required whatever the approach to assess excess tissue height , width and prolapse . Nowadays it seems that two different ways of treating mitral prolapse coexist : the non resection one and the resection one .Both will be discussed and analysed . Similarly the use of artificial chordae seem to have a preponderant role to support the free edge and correct a prolapse . Native secondary chord transfer are easy and reliable but seem abandoned by many . Anterior leaflet prolapse is also dealt with and fewer options are available to address this leaflet . Then commissural prolapse is mentioned . It is an important area of the valve which should deserve better treatment than commissuroplasty . Finally a special entity will be described ; mitro annular disjonction . The approach is not or no longer an issue as only good long term results are important in an era where per cutaneous therapy is the only non invasive technique .
17 Sep 2022Reviewer(s) Assigned
18 Sep 2022Review(s) Completed, Editorial Evaluation Pending
18 Sep 2022Editorial Decision: Accept