Barlow's disease illustrated by a clinical case

Barlow's disease (BD) is one of the dominant forms of degenerative mitral valve (MV) disease characterized by morphological changes of the connective tissue triggering the mechanism of mitral valve leaflet coaptation failure. The disease is characterized by MV prolapse driven by chordal rupture or elongation, leaflet area enlargement and annular ectasia. Typical BD symptoms are found in 24% of patients with mitral valve prolapse (MPV). It should be noted that BD is a heritable disorder. Patients with BD are typically young women (less than 40-year-old), who remain asymptomatic for a long time. BD is often diagnosed incidentally, during the screening examination. Radical correction of such MV dysfunction can be achieved only by using surgical techniques. Based on echocardiography findings, two types of Barlow's disease are distinguished: a classical one with MV leaflet thickening and a non-classical — without its thickening (presumably associated with dysplasia of the connective tissue). This article is focused on the foundations of semiotics and the main principles of BD patient management. It provides a review of MVP and mitral incompetence causes and describes a clinical case of surgical BD treatment. KEYWORDS: mitral regurgitation, plastic surgery of the mitral valve, Barlow's disease, mitral valve prolapse, heritable disorders of connective tissue, dysplasia. FOR CITATION: Reznik E.V., Golubev Yu.Yu., Yurtaeva N.V. et al. Barlow's disease illustrated by a clinical case. Russian Medical Inquiry. 2023;7(1):41–48 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-41-48.