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Mitral valve repair in Barlow’s disease by chordal reconstruction using the adjustable slip-knot technique

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Abstract

The adjustable slip-knot technique—a procedure for facilitating repair of the mitral valve prolapse—was first performed and reported by us in 2015. This technique comprises six steps: anchor institution in the papillary muscle, flexible band positioning, saline injection to confirm the prolapsing site, neochorda setting between the anchor and leaflet, fine adjustment of the neochordal length, and knot-fixing to confirm repair. Here, we have described the first case of successful mitral valve repair using the adjustable slip-knot technique in a 51-year-old man with Barlow’s disease.

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Author information

Correspondence to Mitsuhiro Yano.

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The authors declare that they have no conflict of interest.

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Video 1. Preoperative transesophageal echocardiography revealed a markedly enlarged mitral annulus and billowing of both the leaflets with prolapse (MPG 5822 KB)

Video 1. Preoperative transesophageal echocardiography revealed a markedly enlarged mitral annulus and billowing of both the leaflets with prolapse (MPG 5822 KB)

Video 2. A markedly enlarged mitral annulus, billowed and thickened leaflets, and elongated chordae tendineae were observed (MPG 6586 KB)

Video 2. A markedly enlarged mitral annulus, billowed and thickened leaflets, and elongated chordae tendineae were observed (MPG 6586 KB)

Video 3. A sequence of mitral valve repair according to the adjustable slip-knot technique (MPG 3852 KB)

Video 3. A sequence of mitral valve repair according to the adjustable slip-knot technique (MPG 3852 KB)

Video 4. Intraoperative transesophageal echocardiography after completing the repair (MPG 5634 KB)

Video 4. Intraoperative transesophageal echocardiography after completing the repair (MPG 5634 KB)

Video 5. Transthoracic echocardiography before hospital discharge revealed a trivial regurgitation (MPG 142800 KB)

Video 5. Transthoracic echocardiography before hospital discharge revealed a trivial regurgitation (MPG 142800 KB)

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Yano, M., Nishimura, M., Yokota, A. et al. Mitral valve repair in Barlow’s disease by chordal reconstruction using the adjustable slip-knot technique. Gen Thorac Cardiovasc Surg 68, 63–66 (2020). https://doi.org/10.1007/s11748-018-1004-0

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Keywords

  • Barlow’s disease
  • Mitral valve repair
  • ePTFE
  • Slip knot