Barlow’s Syndrome is a relatively common condition that may result in the leaftlets of the mitral valve bulging into the left atrium of the heart, just as the valve closes during ventricular contraction. This abnormality is due to degeneration of the tissue, causing the mitral valve leaflets to become stretched and enlarged. The redundant tissue prevents the valve from closing properly, often resulting in prolapse of the mitral leaflets and mitral valve regurgitation.

Barlow’s syndrome occurs in 1% to 6% of otherwise normal populations. However, people with Graves’ disease, Marfan’s syndrome, Duchenne muscular dystrophy, myotonic dystrophy, sickle cell disease, and rheumatic heart disease have a higher incidence of this condition.

Symptoms can include fatigue, migraines, dizziness, panic attacks, low blood pressure, shortness of breath, palpitations, and chest pains that are not associated with angina.

The diagnosis and degree of mitral regurgitation is determined by echocardiogram. More specific morphology of the mitral valve can be analyzed by transesophageal echocardiogram (TEE), especially when planning for mitral valve repair surgery.

Mitral valve repair surgery can be done successfully in more than 95% of cases, without the need to replace the valve.

This video illustrates a case of a 60-year-old man with Barlow’s syndrome, who underwent a successful mitral valve repair operation, utilizing pledged 5–0 Gore-Tex neo-chord sutures through the prolapsed posterior mitral valve leaflet, along with placement of a 36mm Edwards Physio-I mitral angioplasty ring. A 50mm AtriCure AtriClip was placed at the base of the left atrial appendage to occlude it and thus reduce the risk of potential stroke from post-operative or future bouts atrial fibrillation.