Hieu Luong Cong, Dinh Nguyen Hoang, Luan Tran Minh Bao, Anh Pham Tho Tuan
Department of Cardiovascular and Thoracic Surgery, Hoan My Sai Gon Hospital, Ho Chi Minh City, Vietnam.
Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Acta Inform Med. 2025;33(2):107-111. doi: 10.5455/aim.2025.33.107-111.
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.
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.
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.
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.
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.
巴洛氏病的特征是存在过多的黏液瘤样退行性组织、瓣叶脱垂和/或膨出、腱索延长以及瓣环扩张。目前有多种二尖瓣修复技术在使用。传统上采用切除技术。非切除技术已得到推广；然而，其在巴洛氏病中的疗效尚不清楚。
本研究旨在评估与切除方法相比，采用非切除方法进行微创二尖瓣修复治疗巴洛氏病患者的早期结局。
我们回顾了采用微创二尖瓣修复非切除技术治疗这种复杂二尖瓣病变的经验。在2020年至2024年期间，一组61例患者被确定为患有巴洛氏病并接受了微创二尖瓣修复。巴洛氏病的诊断基于术前超声心动图，并由外科医生在手术期间进行评估确认。数据收集于胡志明市的医学大学中心（UMC）。
共有61例患者符合纳入标准。57例患者（93.4%）成功完成瓣膜修复。在接受修复的57例患者中，26例患者（45.6%）采用非切除方法进行二尖瓣修复，而31例患者（54.4%）采用切除方法治疗。平均体外循环时间和主动脉阻断时间分别为146.1±23.8分钟和84.6±15.9分钟。在术后30天的随访期间，未观察到死亡或收缩期前向运动（SAM）并发症，术后有1例中度二尖瓣反流。此外，随访期间无需再次手术。
微创巴洛氏二尖瓣修复术后30天结局良好。非切除方法可行且与切除方法一样安全。
