Advertisement

Current concepts in Barlow’s valve reconstruction

  • J.G. Castillo
  • A.C. Anyanwu
  • D.H. Adams

Abstract

Degenerative mitral valve diseases constitute a spectrum of lesions, varying from simple chordal rupture involving prolapse of an isolated segment in an otherwise normal valve to multisegmental prolapse involving one or both leaflets in a valve with significant excess tissue and a large annular size. Barlow syndrome is the most advanced and complex entity in this spectrum and is distinguished by the characteristic presence of diffuse and complex redundancy of the valve due to myxomatous degeneration (◘ Fig. 12.1a), producing prolapse of multiple segments in one or both leaflets (◘ Fig. 12.1b). Severe annular dilatation with giant valve size is evident (ring size ≥36 mm). In addition, varying degrees of annular calcification is often observed, as well as subvalvular fibrosis and calcification of the papillary muscles, in particular the anterior papillary muscle (◘ Fig. 12.1c). Therefore, surgical repair of the Barlow valve may present specific challenges. In this chapter, we describe our systematic approach to Barlow valve repair; we have found it to possible to repair essentially all Barlow valves by consistent application of the outlined principals.

Keywords

Mitral Valve Repair Anterior Leaflet Posterior Leaflet Annuloplasty Ring Systolic Anterior Motion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Carpentier A (1983) Cardiac valve surgery–the »French correction«. J Thorac Cardiovasc Surg 86:323–337PubMedGoogle Scholar
  2. 2.
    Anyanwu AC, Adams DH (2007) The intraoperative »ink test«: a novel assessment tool in mitral valve repair. J Thorac Cardiovasc Surg 133:1635–1636PubMedCrossRefGoogle Scholar
  3. 3.
    Adams DH, Kadner A, Chen RH (2001) Artificial mitral valve chordae replacement made simple. Ann Thorac Surg 71:1377–1378; discussion 1378–1379Google Scholar
  4. 4.
    Carpentier A, Adams DH, Filsoufi F (2010) Carpentier’s reconstructive valve surgery. Elsevier Saunders, ISBN: 978-0-7216-9168-8Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • J.G. Castillo
    • 1
  • A.C. Anyanwu
    • 1
  • D.H. Adams
    • 1
  1. 1.Department of Cardiothoracic SurgeryThe Mount Sinai Medical CenterNew York, NYUSA

Personalised recommendations