Early Results of Minimally Invasive Mitral Valve Repair with Non-Resection Techniques in the Treatment of Barlow Disease.

Abstract

Background: Barlow's disease is characterized by excess myxomatous degenerative tissue, leaflets prolapse and/or billowing, chordal-elongation, and annular dilation. Various mitral valve repair techniques are in use. Resection techniques were conventionally performed. Non-resection techniques have been popularized; however, their efficacy in Barlow's disease is yet unclear.

Objective: This study aimed to evaluate the early outcomes of minimally invasive mitral valve repair with non-resection approach compared to resection approach in patients with Barlow's disease.

Methods: We reviewed our experience in minimally invasive mitral valve repair non-resection techniques to treat this complex mitral pathology. Between 2020 and 2024 a group of 61 patients was identified as Barlow's disease undergoing minimally invasive mitral valve repair. The diagnosis of Barlow disease was based upon preoperative echocardiography and confirmed by the surgeon's assessment during operation. Data were collected at the Medical University Center (UMC) in Ho Chi Minh City.

Results: A total of 61 patients met the inclusion criteria. Successful valve repair was achieved in 57 patients (93.4%). Among the 57 patients who underwent repair, 26 patients (45.6%) received mitral valve repair using the non-resection approach, while 31 patients (54.4%) were treated with the resection approach. The mean cardiopulmonary bypass time and aortic cross-clamp time were 146.1 ± 23.8 minutes and 84.6 ± 15.9 minutes, respectively. During the 30-day postoperative follow-up, no mortality or SAM (systolic anterior motion) complications were observed, with one case of moderate mitral regurgitation post-surgery. Additionally, no reoperations were required during the follow-up period.

Conclusion: Minimally invasive Barlow mitral valve repair has favorable 30-day postoperative outcomes. The non-resection approach is feasible and as safe as the resection approach.