{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:00:57Z","timestamp":1793059257257,"version":"4.5.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007653","name":"Universit\u00e4tsklinikum Jena","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007653","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>Barlow\u00b4s disease represents a wide spectrum of mitral valve pathologies associated with regurgitation (MR), excess leaflet tissue, and prolapse. Repair strategies range from complex repairs with annuloplasty plus neochords through resection to annuloplasty-only. The latter requires symmetric prolapse patterns and central regurgitant jets. We aimed to assess repair success and durability, survival, and intraoperative outcomes with symmetric and asymmetric Barlow\u2019s disease.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Between 09\/10 and 03\/20, 103 patients (of 1939 with mitral valve surgery) presented with Barlow\u00b4s disease. All received surgery through mini-thoracotomy with annuloplasty plus neochords (<jats:italic>n<\/jats:italic>\u2009=\u200971) or annuloplasty-only (<jats:italic>n<\/jats:italic>\u2009=\u200931). One valve was replaced for endocarditis (repair rate: 99%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Annuloplasty-only patients were older (64\u2009\u00b1\u200916 vs. 55\u2009\u00b1\u200911\u00a0years, <jats:italic>p<\/jats:italic>\u2009=\u20090.008) and presented with higher risk (EuroSCORE II: 4.2\u2009\u00b1\u20094.9 vs. 1.6\u2009\u00b1\u20091.7, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). Annuloplasty-only patients had shorter cross-clamp times (53\u2009\u00b1\u200918\u00a0min vs. 76\u2009\u00b1\u200923\u00a0min, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and received more tricuspid annuloplasty (15.5% vs. 48.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Operating times were similar (170\u2009\u00b1\u200941\u00a0min vs. 164\u2009\u00b1\u200935, <jats:italic>p<\/jats:italic>\u2009=\u20090.455). In three patients, annuloplasty-only caused intraoperative systolic anterior motion (SAM), which was fully resolved by neochords to the posterior leaflet. There were no conversions to sternotomy or deaths at 30-days. Three patients required reoperation for recurrent MR (at 25\u00a0days, 2.8 and 7.8\u00a0years). At the latest follow-up, there was no MR in 81.4%, mild in 14.7%, and moderate in 2.9%. Three patients died due to non-cardiac reasons. Surviving patients report the absence of relevant symptoms.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Minimally-invasive Barlow\u2019s repair is safe with good durability. Annuloplasty-only may be a simple solution for complex but symmetric pathologies. However, it may carry an increased risk of intraoperative SAM.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00392-021-01844-9","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T11:03:28Z","timestamp":1617275008000},"page":"1881-1889","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Minimally-invasive mitral valve repair of symmetric and asymmetric Barlow\u00b4s disease"],"prefix":"10.1007","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2153-2458","authenticated-orcid":false,"given":"Gloria","family":"Faerber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Tkebuchava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Diab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Doenst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"issue":"4","key":"1844_CR1","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/0002-9149(85)90402-3","volume":"55","author":"JB Barlow","year":"1985","unstructured":"Barlow JB, Pocock WA (1985) Billowing, floppy, prolapsed or flail mitral valves? 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