Repair of mitral valve billowing and prolapse (Barlow): the surgical technique.

Mitral valve repair in patients with mitral valve billowing and prolapse (Barlow) can be a demanding surgical procedure. A mitral valve repair method, which incorporates the complete resection of the middle scallop of the posterior leaflet, a sliding and folding plasty with the remaining lateral scallops combined with a triangular resection of the anterior leaflet and a ring-annuloplasty was developed, which maximizes predictable anatomic and physiologic efficacy of this repair and minimizes unpredictable results. A total of 37 consecutive patients underwent mitral repair with this method from 1996 to 1998, with consistently excellent results. Short-term follow-up information collected after 22.7 +/- 8.6 months showed one late death and 93.0% of all surviving patients in New York Heart Association functional class I or II. There were no late reoperations and no thromboembolic, bleeding, or other complications. No patient had recurrent mitral regurgitation.