Barlow's Disease: Navigating Long-Term Outcomes and Modern Management Strategies

Barlow’s disease is a primary form of mitral valve prolapse (MVP) characterized by myxomatous degeneration, leading to excessive leaflet thickening, redundancy, and elongation. This structural abnormality can result in progressive mitral regurgitation, predisposing patients to complications such as atrial fibrillation, heart failure, and infective endocarditis. While some individuals remain asymptomatic, others experience significant morbidity, often necessitating medical or surgical intervention. This review aims to (1) understand the pathophysiology of Barlow’s disease, (2) evaluate the long-term outcomes in affected patients, and (3) analyze modern management strategies including advanced imaging, risk stratification tools, and minimally invasive mitral valve repair techniques. Recent advancements in diagnostic modalities and surgical approaches have contributed to better patient selection, reduced operative risks, and improved survival and quality of life. By synthesizing current evidence, this article provides a comprehensive overview to guide clinicians in optimizing long-term care and outcomes in patients with Barlow’s disease.