Mitral Annular Disjunction-A New Disease Spectrum

Area of Science:

• Cardiology
• Cardiac Pathology
• Echocardiography

Background:

• Mitral annular disjunction (MAD) is a structural abnormality of the mitral annulus fibrosus.
• MAD is frequently observed in patients with myxomatous mitral valve diseases.
• Pathological descriptions associate MAD with mitral leaflet prolapse.

Purpose of the Study:

• To highlight the potential arrhythmogenic nature of MAD, independent of mitral valve prolapse (MVP).
• To emphasize the importance of routinely checking for MAD during presurgical imaging.
• To encourage echocardiography evaluation with MAD in mind.

Main Methods:

• Review of pathological descriptions and clinical findings related to MAD.
• Analysis of echocardiographic data in patients with myxomatous mitral valve disease.
• Discussion of the potential association between MAD and arrhythmias.

Main Results:

• Mitral annular disjunction is a common finding in patients with myxomatous mitral valve diseases.
• MAD may be an arrhythmogenic entity, irrespective of the presence of mitral valve prolapse.
• Routine screening for MAD during presurgical imaging is suggested.

Conclusions:

• Mitral annular disjunction is a significant finding that warrants attention during cardiac evaluations.
• Further prospective studies are needed to establish a causative link between MAD and arrhythmic MVP.
• Echocardiography should be performed with a specific focus on identifying mitral annular disjunction.