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Current Cardiology Reports
Published in: Current Cardiology Reports 8/2016

01-08-2016 | Valvular Heart Disease (A Wang, Section Editor)

Current Discoveries and Interventions for Barlow’s Disease

Author: Juan A. Siordia

Published in: Current Cardiology Reports | Issue 8/2016

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Abstract

Mitral valve prolapse is a common valve pathology. One particular type of mitral valve prolapse that can be difficult to treat is Barlow’s disease. This review serves to give insight on the current discoveries and therapeutic interventions of Barlow’s disease.
Literature
1.
Barlow JB, Pocock WA, Marchand P, Denny M. The significance of late systolic murmurs. Am Heart J. 1963;66:443–52.CrossRef
2.
3.
Carpentier A, Chauvaud S, Fabiani JN, Deloche A, Relland J, Lessana A, et al. Reconstructive surgery of mitral valve incompetence: ten-year appraisal. J Thorac Cardiovasc Surg. 1980;79:338–48.PubMed
4.
Castillo JG, Anyanwu AC, El-Eshmawi A, Adams DH. All anterior and bileaflet mitral valve prolapses are repairable in the modern era of reconstructive surgery. Eur J Cardiothorac Surg. 2014;45:139–45.CrossRefPubMed
5.
Adams DH, Anyanwu AC. The cardiologist’s role in increasing the rate of mitral valve repair in degenerative disease. Curr Opin Cardiol. 2008;23:105–10.CrossRefPubMed
6.
Whittaker P, Boughner DR, Perkins DG, Canham PB. Quantitative structural analysis of collagen in chordae tendinae and its relation to floppy mitral valves and proteoglycan infiltration. Br Heart J. 1987;57:264–9.CrossRefPubMedPubMedCentral
7.
Tamura K, Fukuda Y, Ishizaki M, Masuda Y, Yamanaka N, Gerrans VJ. Abnormalities in elastic fibers and other connective-tissue components of floppy mitral valve. Am Heart J. 1995;129:1149–58.CrossRefPubMed
8.
Glesby MJ, Pyeritz RE. Association of mitral valve prolapse and systemic abnormalities of connective tissue: a phenotypic continuum. JAMA. 1989;262:523–8.CrossRefPubMed
9.
Nasuti JF, Zhang PJ, Feldman MD, Pasha T, Khurana JS, Goram 3rd JH, et al. Fibrillin and other matrix proteins in mitral valve prolapse syndrome. Ann Thorac Surg. 2004;77:532–6.CrossRefPubMed
10.
11.
Rabkin E, Aikawa M, Stone JR, Fukumoto Y, Libby P, Schoen FJ. Activated interstitial myofibroblasts express catabolic enzymes and mediate matrix remodeling in the myxomatous heart valves. Circulation. 2001;104:2525–32.CrossRefPubMed
12.
Mahimkar R, Nguyen A, Mann M, Yeh CC, Zhu BQ, Karliner JS, et al. Cardiac transgenic matrix metalloproteinase-2 expression induces myxomatous valve degeneration: a potential model of mitral valve prolapse disease. Cardiovasc Pathol. 2009;18:253–61.CrossRefPubMed
13.
Kyndt F, Schott JJ, Trochu JN, Baranger F, Herbert O, Scott V, et al. Mapping of X-linked myxomatous valvular dystrophy to chromosome Xq28. Am J Hum Genet. 1998;62:627–32.CrossRefPubMedPubMedCentral
14.
Bowles KR, Garjaski R, Porter P, Goyta V, Bachinski L, Roberts R, et al. Gene mapping of familial autosomal dominant dilated cardiomyopathy to chromsome 10q21-23. J Clin Invest. 1996;987:1355–60.CrossRef
15.
Disse S, Abergel E, Berrebi A, Houot AM, Le Heuzey JY, Diebold B, et al. Mapping of a first locus for autosomal dominant myxomatous mitral-valve prolapse to chromosome 16p11.2-p12.1. Am J Hum Genet. 1999;65:1242–51.CrossRefPubMedPubMedCentral
16.
Devereux RB, Brown WT, Kramer-FOx R, Sachs I. Inheritance of mitral valve prolapse: effect on age and sex on gene expression. Ann Intern Med. 1982;97:826–32.CrossRefPubMed
17.
Lerner TJ, Boustany RMN, Anderson JW, D'Arigo KL, Schlumpf K, Buckler AJ, et al. Isolation of a novel gene underlying batten disease, CLN3. Cell. 1995;82:949–57.CrossRef
18.
Augestad LB, FLander WD. Occurrence of and mortality from childhood neuronal ceroid lipofuscinoses in Norway. J Child Neurol. 2006;11:917–22.CrossRef
19.
Hugot JP, Laurent-Puig P, Gower-Rousseau C, Olson JM, Lee JC, Beaugerie L, et al. Mapping a susceptibility locus for Crohn's disease on chromosome 16. Nature. 1996;379:821–3.CrossRefPubMed
20.
Struk B, Neldner KH, Rao VS, St Jean P, Lindpaintner K. Mapping of both autosomal recessive and dominant variants of pseudoxanthoma elasticum to chromosome 16p13.1. Hum Mol Genet. 1997;6:1823–8.CrossRefPubMed
21.
Anyanwu AC, Adams DH. Etiologic classification of degenerative mitral valve disease: Barlow’s disease and fibroelastic deficiency. Semin Thorac Cardiovasc Surg. 2007;19:90–6.CrossRefPubMed
22.
23.•
Chandra A, Salgo IS, Sugeng L, Weinert L, Tsang M, Takeuchi KT, et al. Characterization of degenerative mitral valve disease using morphologic analysis of real-time three-dimensional echocardiographic images: objective insight into complexity and planning of mitral valve repair. Circ Cardiovasc Imaging. 2011;4:24–32. This reference gives large insight and information about the presentations of patients with BD in the clinical and radiological (echocardiography) setting.CrossRefPubMed
24.
Fusini L, Ali SG, Tamborini G, Muratori M, Gripari P, Maffessanti F, et al. Prevalence of calcification of the mitral valve annulus in patients undergoing surgical repair of mitral valve prolapse. Am J Cardiol. 2014;113:1867–73.CrossRefPubMed
25.
Yiginer O, Keser N, Ozmen N, Tokatli A, Kardesglu E, Isilak Z, et al. Classic mitral valve prolapse causes enlargement in left ventricle even in the absence of significant mitral regurgitation. Echocardiography. 2012;29:123–9.CrossRefPubMed
26.
Yiginer O, Tokatli A, Dogan M, Ozmen N. Independently from mitral regurgitation, Barlow disease may cause left ventricular enlargement and therapy anticipation of surgery. Ital J Anat Embryol. 2015;120:1–2.PubMed
27.
Adams DH, Anyanwu AC, Rahmanian PB, Abascal V, Salzberg SP, Filsoufi F. Large annuloplasty rings facilitate mitral valve repair in Barlow’s disease. Ann Thorac Surg. 2006;82:2096–100.CrossRefPubMed
28.
Aalberts JJJ, Van Tintelen JP, Oomen T, Bergman JEH, Halley DJJ, Jongbloed JDH, et al. Screening of TGFBR1, TGFBR2, and FLNA in familial mitral valve prolapse. Am J Med Genet A. 2013;164:113–9.CrossRef
29.
Maffessanti F, Marsan NA, Tamborini G, Sugeng L, Caiani EG, Gripari P, et al. Quantitative analysis of mitral valve apparatus in mitral valve prolapse before and after annuloplasty: a three-dimensional intraoperative transesophageal study. J Am Soc Echocardiogr. 2011;24:405–13.CrossRefPubMed
30.
Malkowski MJ, Boudoulas H, Wooley CF, Guo R, Pearson AC, Gray PG. Spectrum of structural abnormalities in floppy mitral valve echocardiographic evaluation. Am Heart J. 1996;132:145–51.CrossRefPubMed
31.
Matsumaru I, Eishi K, Hashizume K, Kawano H, Tsuneto A, Hayashi T. Clinical and pathological features of degenerative mitral valve disease: billowing mitral leaflet versus fibroelastic deficiency. Ann Thorac Cardiovasc Surg. 2014;20:987–94.CrossRefPubMed
32.
Gupta V, Barzilla JE, Mendez JS, Stephens EH, Lee EL, Collard CD, et al. Abundance and location of proteoglycans and hyaluronan within normal and myxomatous mitral valves. Cardiovasc Pathol. 2009;18:191–7.CrossRefPubMed
33.
Grande-Allen KJ, Griffin BP, Ratliff NB, Cosgrove DM, Vesely I. Glycosaminoglycan profiles of myxomatous mitral leaflets and chordae parallel the severity of mechanical alteraltions. J Am Coll Cardiol. 2003;42:271–7.CrossRefPubMed
34.
Grande-Allen KJ, Calabro A, Gupta V, Wight TN, Hascall VC, Vesely I. Glycosaminoglycans and proteoglycans in normal mitral valve leaflets and chordae: association with regions of tensile and compressive loading. Glycobiology. 2004;14:621–33.CrossRefPubMed
35.
Reed CC, Iozzo RV. The role of decorin in collagen fibrillogenesis and skin homeostasis. Glycoconj J. 2002;19:249–55.CrossRefPubMed
36.
Wight TN. Versican: a versatile extracellular matrix proteoglycan in cell biology. Curr Opin Cell Biol. 2002;14:617–23.CrossRefPubMed
37.
Akhtar S, Meek KM, James V. Ultrastructure abnormalities in proteoglycans, collagen fibrils, and elastic fibers in normal and myxomatous mitral valve chordae tendineae. Cardiovasc Pathol. 1999;8:191–201.CrossRefPubMed
38.
Baker PB, Bansal G, Boudoulas H, Kolibash AJ, Kilman J, Wooley CF. Floppy mitral valve chordae tendineae: histopathologic alterations. Hum Pathol. 1988;19:507–12.CrossRefPubMed
39.
Scott-Jupp W, Barnett NL, Gallagher PJ, Monro JL, Ross JK. Ultrastructural changes in spontaneous rupture of mitral chordae tendineae. J Pathol. 1981;133:185–201.CrossRefPubMed
40.
Fornes P, Heudes D, Fuzellier JF, Tixier D, Bruneval P, Carpentier A. Correlation between clinical and histologic patterns of degenerative mitral valve insufficiency: a histomorphometric study of 130 excised segments. Cardiovasc Pathol. 1999;8:81–92.CrossRefPubMed
41.
Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, Detaint D, Capps M, Nkomo V, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med. 2005;352:875–83.CrossRefPubMed
42.
Savage EB, Ferguson Jr TB, Di Sesa VJ. Use of mitral valve repair: analysis of contemporary United States experience reported to the Society of Thoracic Surgeons National Cardiac Database. Ann Thorac Surg. 2003;75:820–5.CrossRefPubMed
43.•
Rostagno C, Droandi G, Rossi A, Bevilacqua S, Romagnli S, Montesi GF, et al. Anatomic characteristics of bileaflet mitral valve prolapse—Barlow disease—in patients undergoing mitral valve repair. Ital J Anat Embryol. 2014;119:20–8. This reference gives insight in the clinical presentation and the surgical repair techniques for BD. It also gives evidence to the improvements of mitral valve repair and annuloplasty.PubMed
44.
Flameng W, Meuris B, Herijgers P, Herregods M. Durability of mitral valve repair in Barlow disease versus fibroelastic deficiency. J Thorac Cardiovasc Surg. 2008;135:274–82.CrossRefPubMed
45.
Carpentier AF, Lessana A, Relland JY, Belli E, Mihaileanu S, Berrebi AJ, et al. The “Physio-Ring”: an advanced concept in mitral valve annuloplasty. Ann Thorac Surg. 1995;60:1177–85.CrossRefPubMed
46.
Phillips MR, Daly RC, Schaff HV, Dearani JA, Mullany CJ, Orszulak TA. Repair of anterior leaflet mitral valve prolapse: chordal replacement versus chordal shortening. Ann Thorac Surg. 2000;69:25–9.CrossRefPubMed
47.
David TE, Omran A, Armstrong S, Sun Z, Ivanov J. Long-term results of mitral valve repair for myxomatous disease with and without chordal replacement with expanded polytetrafluoroethylene sutures. J Thorac Cardiovasc Surg. 1998;115:1279–86.CrossRefPubMed
48.
Mihaileanu S, Marino JP, Chauvaud S, Perier P, Forman J, Vissoat J, et al. Left ventricular outflow obstruction after mitral valve repair (Carpentier’s technique): proposed mechanisms of disease. Circulation. 1998;78:78–84.
49.
Jebara VA, Mihaileanu S, Acar C, Brizard C, Grare P, Latremouille C, et al. Left ventricular outflow tract obstruction after mitral valve repair: results of the sliding leaflet technique. Circulation. 1993;88:30–4.
50.
Perier P, Clausnizer B, Mistarz K. Carpentier “sliding leaflet” technique for repair of the mitral valve: early results. Ann Thorac Surg. 1994;57:383–6.CrossRefPubMed
51.
Quigley RL. Prevention of systolic anterior motion after repair of the severely myxomatous mitral valve with an anterior leaflet valvuloplasty. Ann Thorac Surg. 2005;80:179–82.CrossRefPubMed
52.
Maisano F, Schreuder JJ, Oppizzi M, Fiorani B, Fino C, Alfieri O. The double-orifice technique as a standardized approach to treat mitral regurgitation due to severe myxomatous disease: surgical technique. Eur J Cardiothorac Surg. 2000;17:201–5.CrossRefPubMed
53.
Cosgrove 3rd DM, Arcidi JM, Rodriguez L, Stewart WJ, Powell K, Thomas JD. Initial experience with the Cosgrove-Edwards Annuloplasty System. Ann Thorac Surg. 1995;60:499–503.CrossRefPubMed
54.
Gatti G, Pugliese P. Preliminary experience in mitral valve repair using the Cosgrove-Edwards annuloplasty ring. Interact Cardiovasc Thorac Surg. 2003;2:256–61.CrossRefPubMed
55.
Barlow CW, Ali ZA, Lim E, Barlow JB, Wells FC. Modified technique for mitral repair without ring annuloplasty. Ann Thorac Surg. 2003;75:298–300.CrossRefPubMed
56.
Pasic M, von Segesser L, Niederhauser U, Vogt P, Jenni R, Turina M. Outflow tract obstruction after mitral repair without an annuloplasty ring. Eur J Cardiothorac Surg. 1995;9:283–5.CrossRefPubMed
57.
Aybek T, Risteski P, Miskovic A. Seven years’ experience with suture annuloplasty for mitral valve repair. J Thorac Cardiovasc Surg. 2006;131:99–106.CrossRefPubMed
58.
Gillinov AM, Cosgrove DM, Blackstone EH, Diaz R, Arnold JH, Lytle BW, et al. Durability of mitral valve repair for degenerative disease. J Thorac Cardiovasc Surg. 1998;116:734–43.CrossRefPubMed
59.
David TE, Burns RJ, Bacchus CM, Druck MN. Mitral valve replacement for mitral regurgitation with and without preservation of chordae tendineae. J Thorac Cardiovasc Surg. 1984;88:718–25.PubMed
60.
Madesis A, Tsakiridis K, Zarogoulidis P, Katsikogiannis N, Machairiotis N, Kougioumtzi I, et al. Review of mitral valve insufficiency: repair or replacement. J Thorac Dis. 2014;6:s39–51.PubMedPubMedCentral
61.
Gillinov AM, Blackstone EH, Nowicki ER, Slisatkorn W, Al-Dossari G, Johnston DR, et al. Valve repair versus valve replacement for degenerative mitral valve disease. J Thorac Cardiovasc Surg. 2008;135:885–93.CrossRefPubMed
62.
Melnitchouk SI, Seeburger J, Kaeding AF, Misfeld M, Mohr FW, Borger MA. Barlow’s mitral valve disease: results of conventional and minimally invasive repair approaches. Ann Cardiothorac Surg. 2013;2:768–73.PubMedPubMedCentral
63.
Bhamra-Ariza P, Muller DWM. The MitraClip experience and future percutaneous mitral valve therapies. Heart Lung Circ. 2014;23:1009–19.CrossRefPubMed
64.
Chan PH, She HL, Alegria-Barrero E, Moat N, Mario CD, Franzen O. Real-world experience of MitraClip for treatment of severe mitral regurgitation. Circ J. 2012;76:2488–93.CrossRefPubMed
65.
Rogers JH, Olaf F. Percutaneous edge-to-edge MitraClip therapy in the management of mitral regurgitation. Eur Heart J. 2011;32:2350–7.CrossRefPubMed
66.
Conradi L, Treede H, Franzen O, Seiffert M, Baldus S, Schirmer J, et al. Impact of MitraClip therapy on secondary mitral valve surgery in patients at high surgical risk. Eur J Cardiothorac Surg. 2011;40:1521–8.PubMed
67.
Maisano F, Alfieri O, Banai S, Buchbinder M, Colombo A, Falk V, et al. The future of transcatheter mitral valve interventiona: competitive or complementary role of repair vs. replacement? Eur Heart J. 2015;36:1651–9.CrossRefPubMed
Metadata
Title
Current Discoveries and Interventions for Barlow’s Disease
Author
Juan A. Siordia
Publication date
01-08-2016
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 8/2016
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-016-0754-5

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