The double-orifice technique as a standardized approach to treat mitral regurgitation due to severe myxomatous disease: Surgical technique

Francesco Maisano, Jan J. Schreuder, Michele Oppizzi, Brenno Fiorani, Carlo Fino, Ottavio Alfieri

Research output: Contribution to journalArticle


Objectives: Mitral-valve repair in Barlow's disease is challenging; conventional techniques are difficult to perform, and there is a high risk of a postoperative suboptimal result. Double-orifice repair has been applied in a standardized approach to treat patients with severe mitral regurgitation and bileaflet prolapse due to Barlow's disease. Methods: Since 1993, 82 patients with severe mitral regurgitation due to Barlow's disease underwent correction applying the edge-to-edge concept. They were submitted to double-orifice repair in a standardized fashion, suturing the middle portions of both leaflets. Results: There were no hospital deaths. The repair was unsatisfactory in one patient who underwent valve replacement soon after the repair. The mean postoperative valve area was 3.7±0.79 cm2 against a mean preoperative value of 9.2±2.1 cm2. No or mild regurgitation was found in all but three patients who showed moderate residual regurgitation. There were no late deaths. Freedom from reoperation was 86±14% at 5 years. At the latest follow-up, all patient but one were New York Heart Association (NYHA) functional class I, and echo-Doppler assessment of valve reconstruction showed stable valve function in all patients. Conclusions: The double-orifice repair can be used as a standardized approach to treat valve regurgitation due to Barlow disease with low risk and good early and mid-term results. Copyright (C) 2000 Elsevier Science B.V.

Original languageEnglish
Pages (from-to)201-205
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number3
Publication statusPublished - Mar 1 2000



  • Barlow's disease
  • Mitral regurgitation
  • Mitral-valve prolapse
  • Valve repair

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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