Skip to main content

01.02.2015 | Current Topics Review Article | Ausgabe 2/2015

General Thoracic and Cardiovascular Surgery 2/2015

Technical aspects of mitral valve repair in Barlow’s valve with prolapse of both leaflets: triangular resection for excess tissue, sophisticated chordal replacement, and their combination (the restoration technique)

General Thoracic and Cardiovascular Surgery > Ausgabe 2/2015
Takashi Miura, Tsuneo Ariyoshi, Kazuyoshi Tanigawa, Seiji Matsukuma, Shougo Yokose, Mizuki Sumi, Kazuki Hisatomi, Akira Tsuneto, Koji Hashizume, Kiyoyuki Eishi
Wichtige Hinweise
Presented at the 65th Annual Scientific Meeting of The Japanese Association for Thoracic Surgery, Postgraduate Course.
This review was submitted at the invitation of the editorial committee.



Histological degeneration in Barlow’s valve mainly starts in the rough zone, frequently expands toward the chordae, and advances to the clear zone, resulting in a saccular aneurysm-like morphology in the prolapsed region. On this basis, we have repaired the prolapsed segment by triangular resection, chordal replacement and the combination (the restoration technique). The aim of this study was to report our initial findings and evaluate the efficacy of our technique.


Twelve patients diagnosed with Barlow’s valve with prolapse of both leaflets (5 women; mean age, 49 years) underwent the restoration technique between January 2008 and March 2013. We retrospectively reviewed short-term clinical outcomes. The mean duration of the clinical follow-up was 2.5 ± 1.7 years.


The restoration technique was successfully performed in all patients. Predominant repair techniques were isolated triangular resection (anterior 8, posterior 9), a combination of triangular resection with chordal replacement (anterior 1, posterior 1), and isolated chordal replacement (anterior 3, posterior 1). All patients underwent complete mitral annuloplasty, and the mean ring size was 31 ± 2 mm. In-hospital mortality was not noted. Late transthoracic echocardiography showed no or trace mitral regurgitation without significant systolic anterior motion in all patients. The New York Heart Association functional class was significantly improved from 1.3 ± 0.5 before surgery to 1.0 ± 0.0 after it (p < 0.01). There were no late thromboembolic or bleeding events.


Initial experience with the restoration technique has provided excellent results without significant systolic anterior motion. Our technique may contribute to improve late results in Barlow’s valve.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt e.Med zum Sonderpreis bestellen!

Weitere Produktempfehlungen anzeigen
Über diesen Artikel

Weitere Artikel der Ausgabe 2/2015

General Thoracic and Cardiovascular Surgery 2/2015 Zur Ausgabe
  1. Sie können e.Med Chirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.