How to do itRepair of mitral valve billowing and prolapse (Barlow): the surgical technique
Section snippets
Technique
Surgery was performed in ischemic cardiac arrest under cardiopulmonary bypass with moderate systemic hypothermia. The interatrial groove was incised and the right atrium dissected. With the left atrial roof exposed, the left atrial incision was carried out close to the mitral valve. A self-retaining retractor was used to expose the mitral valve. Accurate valve analysis using the two conceptual approaches, ie, functional and segmental, as advocated by Carpentier, was mandatory [6].
To reduce the
Comment
Mitral valve billowing and prolapse (Barlow) still remains a somewhat mysterious disease [4]. Probably because of the imprecise terminology, the frequency of progressive mitral valve regurgitation requiring subsequent surgery in patients with mitral billowing and prolapse remains hidden. On reviewing the literature it is evident that some confusion exists on mitral valve prolapse, as there is no uniform terminology and definition [9]. However, Barlow recommended accepting the concept of
Acknowledgements
The surgical procedures and collection of data for this manuscript have been performed at the Herz-Gefaess-Klinik GmbH Bad Neustadt, Germany, where the author was previously associated.
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