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Published on: February 11, 2022
Mitral Annular Disruptions
Rachel L Goldberg1, Eric Isselbacher1, Sean P Murphy2
1Cardiovascular Disease Division, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Background:
Mitral annular disruption is increasingly recognized in our clinical practice and is most commonly due to infective endocarditis or transcatheter or hybrid balloon-expandable mitral valve deployment in the setting of mitral annular calcification.
Case Summary:
A case series is presented of 4 patients with mitral annular disruption in 4 distinct clinical scenarios, each requiring multimodality imaging for diagnosis.
Discussion:
These defects are often difficult to detect on transthoracic imaging and challenging to interpret on transesophageal echocardiography given the unique flow pattern and a general unfamiliarity among echocardiographers with such a defect.
Take-Home Messages:
These 4 cases describe mitral annular disruption caused by infective endocarditis or mitral valve replacement in the setting of mitral annular calcification. These cases stress the importance of careful multimodality cardiac imaging and maintaining a high clinical suspicion for mitral annular disruption, as it is often challenging to diagnose.
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