Barlow's disease illustrated by a clinical case
DOI: 10.32364/2587-6821-2023-7-1-41-48
E.V. Reznik1,2, Yu.Yu. Golubev1, N.V. Yurtaeva3, D.V. Zayats3, G.Yu. Ishchenko4, A.I. Katkov1,5, D.V. Puzenko1,5, E.A. Novikova5, P.V. Lednev6, G.N. Golukhov2
1Pirogov Russian National Research Medical University, Moscow, Russian Federation
2Academician G.M. Savel'eva City Clinical Hospital No. 31, Moscow, Russian Federation
3Central Polyclinic of the FSB of Russia, Moscow, Russian Federation
4Autonomous Non-commercial Organization Central Clinical Hospital of Svyatitel Aleksiy, Moscow, Russian Federation
5N.N. Blokhin National Medical Research Center, Moscow, Russian Federation
6Academician B.V. Petrovskiy Russian Scientific Center of Surgery, Moscow, Russian Federation
Barlow's disease (BD) is one of the dominant forms of degenerative mitral valve (MV) disease characterized by morphological changes of the connective tissue triggering the mechanism of mitral valve leaflet coaptation failure. The disease is characterized by MV prolapse driven by chordal rupture or elongation, leaflet area enlargement and annular ectasia. Typical BD symptoms are found in 24% of patients with mitral valve prolapse (MPV). It should be noted that BD is a heritable disorder. Patients with BD are typically young women (less than 40-year-old), who remain asymptomatic for a long time. BD is often diagnosed incidentally, during the screening examination. Radical correction of such MV dysfunction can be achieved only by using surgical techniques. Based on echocardiography findings, two types of Barlow's disease are distinguished: a classical one with MV leaflet thickening and a non-classical — without its thickening (presumably associated with dysplasia of the connective tissue). This article is focused on the foundations of semiotics and the main principles of BD patient management. It provides a review of MVP and mitral incompetence causes and describes a clinical case of surgical BD treatment.
Keywords: mitral regurgitation, plastic surgery of the mitral valve, Barlow's disease, mitral valve prolapse, heritable disorders of connective tissue, dysplasia.
For citation: Reznik E.V., Golubev Yu.Yu., Yurtaeva N.V. et al. Barlow's disease illustrated by a clinical case. Russian Medical Inquiry. 2023;7(1):41–48 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-41-48.
About the authors:
Elena V. Reznik — Dr. Sc. (Med.), associate professor, Head of the Department of Propedeutics of Internal Diseases, Faculty of General Medicine, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117997, Russian Federation; cardiologist, therapist, functional diagnostics physician, Academician G.M. Savel'eva City Clinical Hospital No. 31; 42, Lobachevskiy str., Moscow, 115516, Russian Federation; ORCID iD 0000-0001-7479-418X.
Yuri Yu. Golubev — C. Sc. (Med.), associate professor of the Department of Propedeutics of Internal Diseases, Faculty of General Medicine, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117997, Russian Federation; ORCID iD 0000-0003-0971-3616.
Natalya V. Yurtaeva — functional diagnostics physician, Central Polyclinic of the FSB of Russia; 5, bldn. 1, Varsonofevsky lane, Moscow, 107031, Russian Federation.
Darya V. Zayats — functional diagnostics physician, Central Polyclinic of the FSB of Russia; 5, bldn. 1, Varsonofevsky lane, Moscow, 107031, Russian Federation.
Galina Yu. Ishchenko — C. Sc. (Med.), therapist, Autonomous Non-commercial Organization Central Clinical Hospital of Svyatitel Aleksiy; 27, Leninsky Prospect, Moscow, 119071, Russian Federation.
Andrey I. Katkov — C. Sc. (Med.), associate professor of the Department of Cardiovascular Surgery, Faculty of Additional Professional Education, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117997, Russian Federation; cardiovascular surgeon, N.N. Blokhin National Medical Research Center; 23, Kashirskoe road, Moscow, 115478, Russian Federation; ORCID iD 0000-0002-2338-089X.
Dmitry V. Puzenko — C. Sc. (Med.), Acting Head of the Department of Cardiovascular Surgery, Faculty of Additional
Professional Education, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117997, Russian Federation; cardiovascular surgeon, N.N. Blokhin National Medical Research Center of Oncology; 23, Kashirskoe road, Moscow, 115478, Russian Federation; ORCID iD 0000-0002-2607-3895.
Ekaterina A. Novikova — cardiologist, N.N. Blokhin National Medical Research Center of Oncology; 23, Kashirskoe road, Moscow, 115478, Russian Federation; ORCID iD 0009-0004-2677-049X.
Pavel V. Lednev — C. Sc. (Med.), cardiovascular surgeon of Cardiac Surgery Department No. 2, Academician B.V. Petrovskiy Russian Scientific Center of Surgery; 2, Abrikosovskiy lane, Moscow, 119991, Russian Federation; ORCID iD 0000-0002-3033-4146.
Georgy N. Golukhov — Dr. Sc. (Med.), Corresponding Member of the Russian Academy of Sciences, Deputy Chairman of the Public Council at the Moscow Health Department; President, Academician G.M. Savel'eva City Clinical Hospital No. 31; 42, Lobachevskiy str., Moscow, 115516, Russian Federation; ORCID iD 0000-0002-0161-005X.
Contact information: Elena V. Reznik, e-mail: elenaresnik@gmail.com.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 14.11.2022.
Revised 07.12.2022.
Accepted 08.02.2023.
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