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Ann Thorac Surg 2005;79:1496-1499
© 2005 The Society of Thoracic Surgeons

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Original articles: Cardiovascular

Minimally Invasive Mitral Valve Repair in the Context of Barlow's Disease

^a Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy
^b Department of Anesthesiology, San Raffaele University Hospital, Milan, Italy

Accepted for publication October 20, 2004.

^_* Address reprint requests to Dr Lapenna, Divisione di Cardiochirurgia, IRCCS Ospedale Universitario San Raffaele, Via Olgettina, 60, 20132 Milan, Italy; (E-mail: lapenna.elisabetta{at}hsr.it).

BACKGROUND: The aim of this study is to report our overall experience with minimally invasive mitral valve repair for correction of severe mitral regurgitation in the setting of Barlow's disease.

METHODS: Between 1999 and 2003, 48 patients with bileaflet prolapse in the context of Barlow's disease underwent minimally invasive mitral valve repair using the "edge-to-edge" technique. Mean age was 37.9 ± 9.1 and 58% were female. Most of the patients were in New York Heart Association (NYHA) class I or II and all of them had normal left ventricular ejection fraction.

RESULTS: There were no conversions to sternotomy. Mean cardiopulmonary bypass and aortic cross-clamp times were 77 ± 16 minutes and 56 ± 8 minutes. No in-hospital deaths and no major postoperative complications occurred. At a mean follow-up of 22.7 ± 10.6 months, survival rate and freedom from reoperation were 100%. All patients were in NYHA class I and in sinus rhythm. No residual mitral regurgitation was detected at echocardiography in 33 (68.7%) patients and mild insufficiency was found in 15 (31.2%). The degree of satisfaction in terms of cosmesis and postoperative pain was very high and 73% of the patients were back to work and to normal activity in 4 weeks.

CONCLUSIONS: Mitral insufficiency due to Barlow's disease can be effectively corrected through a minimally invasive approach by using the "edge-to-edge" technique. In our opinion, the excellent midterm results and the high degree of patients satisfaction certainly justify the adoption of this strategy in a selected group of young and active people.

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