47-year-old man developed severe mitral valve prolapse and atrial fibrillation

Atrial fibrillation is a common consequence of mitral valve prolapse with severe mitral regurgitation. The leaking mitral valve results in an increase in blood volume and pressure in the left atrium which in turn can lead to progressive scarring of the atrial wall, followed by atrial enlargement, and eventually electrical disturbances.

Atrial fibrillation is the most common result and is a serious sequela of mitral prolapse with regurgitation, because it is associated with adverse cardiovascular events and decreased survival. For example, patients with atrial fibrillation associated with valvular heart disease are at an increased risk for embolic stroke from clot forming in the left atrium, particularly in the left atrial appendage.

However, if early surgical intervention with mitral valve repair and a radio-frequency maze procedure is performed, the patients will enjoy normal longevity as well as a markedly improved quality of life.
With permission from this patient to post, this 47-year-old man developed sudden severe mitral regurgitation and atrial fibrillation due to Barlow’s Syndrome—excess mitral leaflet tissue, bi-leaflet prolapse, with rapid atrial fibrillation. His symptoms included extreme lethargy and shortness of breath.

He underwent a complex bi-leaflet mitral valve repair and a radio-frequency maze procedure via a median sternotomy, including a clip occlusion of the left atrial appendage to prevent the risk of embolic strokes in the future.

He is being discharged to home on postoperative day 4 with restoration of normal sinus rhythm and a well-repaired mitral valve. He reports minimal to no incisional discomfort.