Barlow's disease is a term used with several perspectives.
Perspective
Meaning
clinical
late systolic murmur and nonejection systolic click
pathologic
myxoid degeneration of both leaflets of the mitral valve
echocardiographic
prolapse of both the anterior and posterior leaflets (bileaflet prolapse)
surgical management
requires understanding of specific defects in a patient to avoid recurrence; often involves bileaflet resection, posterior sliding plasty plus ring annuloplasty or chordal reimplantation for both leaflets (Speziale et al)
During systole the papillary muscle move toward the mitral annulus rather than the left ventricular apex (systolic papillary muscle traction). This results in excessive stress on chordae and papillary muscles.
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