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Related Concept Videos

Barrett Esophagus-II: Clinical Manifestations and Management01:21

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Respect or resect in Barlow disease.

Gilles D Dreyfus1, Filip Dulguerov2

  • 1Cardiac Surgery, Hopital Europeen Georges Pompidou, Paris, Ile de France, 75015, France.

Journal of Cardiac Surgery
|October 2, 2022
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Summary

Repairing mitral regurgitation in Barlow disease, especially posterior leaflet prolapse, remains complex. This review analyzes various surgical techniques, including resection and non-resection methods, to improve coaptation and long-term outcomes.

Keywords:
Barlowresectrespect

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Repair
  • Mitral Valve Disease

Background:

  • Barlow disease often presents with complex mitral regurgitation, frequently involving the posterior leaflet.
  • Restoring adequate leaflet coaptation is the primary goal in mitral regurgitation repair.
  • Current surgical strategies for mitral valve prolapse are diverse, necessitating careful patient selection.

Purpose of the Study:

  • To review and analyze current surgical techniques for mitral regurgitation in Barlow disease.
  • To discuss the principles of assessing leaflet prolapse and excess tissue.
  • To explore different approaches for anterior leaflet prolapse, commissural prolapse, and specific entities like annular disjunction.

Main Methods:

  • Analysis of existing surgical techniques for mitral regurgitation repair in Barlow disease.
  • Discussion of resection versus non-resection strategies for mitral prolapse.
  • Evaluation of adjunctive methods like artificial chordae and native secondary chord transfer.
  • Review of approaches for specific mitral valve pathologies including anterior leaflet, commissural prolapse, and annular disjunction.

Main Results:

  • Both resection and non-resection techniques for mitral prolapse have their place in surgical management.
  • Artificial chordae and native secondary chord transfer are valuable tools for correcting prolapse.
  • Specific techniques are required for anterior leaflet prolapse, commissural prolapse, and mitral annular disjunction.
  • Long-term outcomes are paramount, especially with the advent of percutaneous therapies.

Conclusions:

  • Successful mitral regurgitation repair in Barlow disease hinges on thorough pre-operative analysis and tailored surgical technique.
  • A comprehensive understanding of various repair options, including less common ones, is crucial for optimal patient outcomes.
  • The focus remains on achieving durable, long-term results in the management of complex mitral valve pathology.