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. 2000 Mar;17(3):201-5.
doi: 10.1016/s1010-7940(00)00351-1.

The double-orifice technique as a standardized approach to treat mitral regurgitation due to severe myxomatous disease: surgical technique

F Maisano  1 , J J Schreuder, M Oppizzi, B Fiorani, C Fino, O Alfieri
Affiliations

The double-orifice technique as a standardized approach to treat mitral regurgitation due to severe myxomatous disease: surgical technique

F Maisano et al. Eur J Cardiothorac Surg. 2000 Mar.

Abstract

Objectives: Mitral-valve repair in Barlow's disease is challenging; conventional techniques are difficult to perform, and there is a high risk of a postoperative suboptimal result. Double-orifice repair has been applied in a standardized approach to treat patients with severe mitral regurgitation and bileaflet prolapse due to Barlow's disease.

Methods: Since 1993, 82 patients with severe mitral regurgitation due to Barlow's disease underwent correction applying the edge-to-edge concept. They were submitted to double-orifice repair in a standardized fashion, suturing the middle portions of both leaflets.

Results: There were no hospital deaths. The repair was unsatisfactory in one patient who underwent valve replacement soon after the repair. The mean postoperative valve area was 3.7+/-0.79 cm(2) against a mean preoperative value of 9.2+/-2.1 cm(2). No or mild regurgitation was found in all but three patients who showed moderate residual regurgitation. There were no late deaths. Freedom from reoperation was 86+/-14% at 5 years. At the latest follow-up, all patient but one were New York Heart Association (NYHA) functional class I, and echo-Doppler assessment of valve reconstruction showed stable valve function in all patients.

Conclusions: The double-orifice repair can be used as a standardized approach to treat valve regurgitation due to Barlow disease with low risk and good early and mid-term results.

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