Mitral Valve Repair of Fibroelastic Deficiency with Posterior Leaflet Prolapse

"In contrast to Barlow’s disease, patients with mitral regurgitation due to fibroelastic deficiency have a lack of connective tissue as the pathological mechanism that triggers leaflet and chordal thinning and eventual chordal rupture. The typical patient with fibroelastic deficiency is over the age of 60 years, and does not have a long history of a heart murmur. Often asymptomatic until the time of chordal rupture, the patient often presents with palpitations or shortness of breath of limited duration. Physical examination is remarkable for a holosystolic murmur, often harsh in nature . In general, a limited quadrangular or triangular resection, or simple leaflet resuspension with a chordal transfer or artificial chord, is all that is required to correct leaflet prolapse. For posterior leaflet prolapse, although the prolapsing segment may look very abnormal, the remainder of the valve is relatively unaffected, so that the surgeon does not usually require advanced techniques to achieve a successful mitral valve reconstruction. In the following video, Dr. David H. Adams performs mitral valve repair surgery of Fibroelastic Deficiency in 50 year old male patient with a posterior leaflet prolapse. Video by David H. Adams, MD."