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April 1, 2021Clinical Research in CardiologyOpen Access

Minimally-invasive mitral valve repair of symmetric and asymmetric Barlow´s disease

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Why the study?

The study aimed to assess repair success, durability, survival, and intraoperative outcomes following minimally-invasive repair of symmetric and asymmetric Barlow disease.

Does minimally-invasive annuloplasty-only compared to annuloplasty plus neochords provide safe and durable repair in patients with Barlow's disease?

Population

103 patients presenting with Barlow disease

Comparison

Annuloplasty plus neochords vs annuloplasty-only

Design

Observational cohort study

Key result

Minimally-invasive mitral valve repair for Barlow's disease achieved a 100% repair success rate in the analyzed cohort, demonstrating that annuloplasty-only is a viable approach for symmetric pathologies.

Authors

GFGloria FaerberSTSophie TkebuchavaMDMahmoud Diab

Discussion

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Overview

Annuloplasty-only may shorten cross-clamp times in symmetric Barlow's but raises SAM risk; leaves open need for randomized comparison on durability.

Study Design

Type

Cohort (n=102)

Multicenter

No

Structured PICO

Does minimally-invasive annuloplasty-only compared to annuloplasty plus neochords provide safe and durable repair in patients with Barlow's disease?

P
Population
102 patients with Barlow's disease undergoing minimally-invasive mitral valve surgery, mean age 55-64 years. Key inclusion: surgical Barlow's disease defined as bileaflet prolapse, diffuse excess of billowing leaflet tissue, and posterior displacement of the posterior annulus.
I
Intervention
Minimally-invasive mitral valve repair with annuloplasty-only (n=31) for symmetric Barlow's disease
C
Comparator
Minimally-invasive mitral valve repair with annuloplasty plus neochords (n=71) for asymmetric Barlow's disease
O
Outcome
Repair success rate

Main Result

Absolute Event Rate: 100% vs 100%

Minimally-invasive annuloplasty-only is a feasible and durable approach for symmetric Barlow's disease, offering shorter cross-clamp times but carrying a higher risk of intraoperative systolic anterior motion compared to annuloplasty with neochords.

Limitations

  • Retrospective single-center experience
  • Follow-up duration may not be considered long-term yet
  • Four patients with symmetric Barlow's pathology and massive excess tissue received annuloplasty plus neochords, limiting conclusions on annuloplasty-only for all symmetric cases
  • Comparison between groups is limited by inter-group differences in baseline characteristics
  • Follow-up may not be considered long-term yet
  • Selection bias (four patients with symmetric Barlow's pathology received annuloplasty plus neochords due to anticipated high risk of SAM)

Cite This Study

Faerber et al. (2021) conducted a cohort in Barlow's disease (n=102). Annuloplasty only vs. Annuloplasty plus neochords was evaluated on Success rate of mitral valve repair. Minimally-invasive mitral valve repair for Barlow's disease achieved a 100% repair success rate in the analyzed cohort, demonstrating that annuloplasty-only is a viable approach for symmetric pathologies.

synapsesocial.com/papers/6a15affea2352da34782c934https://doi.org/10.1007/s00392-021-01844-9
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