Respect or resect in Barlow disease.
Abstract
Mitral regurgitation in Barlow disease may still be challenging to be
repaired . Most often it involves the posterior leaflet . Many
techniques and concepts are currently available ; the main goal being to
restore a good surface of coaptation . Basic principles such a thorough
analysis is still required whatever the approach to assess excess tissue
height , width and prolapse . Nowadays it seems that two different ways
of treating mitral prolapse coexist : the non resection one and the
resection one .Both will be discussed and analysed . Similarly the use
of artificial chordae seem to have a preponderant role to support the
free edge and correct a prolapse . Native secondary chord transfer are
easy and reliable but seem abandoned by many . Anterior leaflet prolapse
is also dealt with and fewer options are available to address this
leaflet . Then commissural prolapse is mentioned . It is an important
area of the valve which should deserve better treatment than
commissuroplasty . Finally a special entity will be described ; mitro
annular disjonction . The approach is not or no longer an issue as only
good long term results are important in an era where per cutaneous
therapy is the only non invasive technique .