Key result
A simple approach using neochordae (the 4-chord technique) can be used to repair bileaflet prolapse in patients with Barlow syndrome and avoid systolic anterior motion.
Why the study?
Surgical repair of Barlow's disease is challenging due to extensive leaflet and annular abnormalities, prompting the need for simple neochordal approaches to repair bileaflet prolapse and avoid systolic anterior motion.
Describes a 4-chord technique using neochordae to repair bileaflet prolapse in Barlow syndrome while avoiding systolic anterior motion.
4-chord technique may aid bileaflet repair in Barlow syndrome; hypothesis-generating and requires randomized confirmation before practice change.
Barlow syndrome is a form of degenerative mitral valve (MV) disease found in a subset of patients with bileaflet prolapse. The hallmark of Barlow's disease includes excessive and billowing leaflet tissue caused by myxomatous tissue proliferation, elongated chordae, and pronounced annular dilatation. Surgical repair of patients with Barlow's disease is challenging due to the extent of the leaflet and annular abnormalities. Several techniques have been described to repair Barlow's MV including currently popular "non-resectional" approaches. Repair with neochordae has been associated with excellent results and includes the advantage of preserved leaflet mobility and a large surface of coaptation. We describe a simple approach to the use of neochordae to repair bileaflet prolapse in patients with Barlow syndrome and avoid systolic anterior motion.
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Chemtob et al. (2019) studied Barlow syndrome with bileaflet prolapse. The 4-chord technique (use of neochordae) was evaluated. A simple approach using neochordae (the 4-chord technique) can be used to repair bileaflet prolapse in patients with Barlow syndrome and avoid systolic anterior motion.
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