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Mitral Valve Surgery with and Without Mitral Annular Disjunction: A Meta-Analysis
Massimo Baudo1, Francesco Cabrucci1,2, Francesca Maria Di Muro3
1Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USA.
Journal of Cardiovascular Development and Disease
|November 26, 2025
Summary
Mitral annular disjunction (MAD) surgery outcomes show patients with MAD have higher risks of ventricular arrhythmias post-operation and long-term. However, overall mortality remains similar compared to those without MAD, necessitating close arrhythmic monitoring.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Mitral annular disjunction (MAD) is increasingly recognized for its clinical importance.
- However, limited data exist on the outcomes of surgical interventions for MAD.
Purpose of the Study:
- To systematically evaluate the efficacy and safety of mitral valve (MV) surgery in patients with MAD.
- To compare outcomes between patients with and without MAD undergoing MV surgery.
Main Methods:
- A systematic review and meta-analysis was conducted.
- Studies comparing MV surgery in patients with and without MAD were included.
- The review was registered in PROSPERO (CRD42025649821).
Main Results:
- Patients with MAD were younger and had more complex valve lesions than those without MAD.
- The MAD cohort showed a higher incidence of ventricular arrhythmias both postoperatively and during follow-up.
- Despite increased arrhythmic events, overall mortality did not significantly differ between groups.
Conclusions:
- Significant baseline differences exist between patients with and without MAD.
- Patients with MAD face a higher risk of postoperative and long-term arrhythmias after MV surgery.
- Close arrhythmic surveillance is crucial for patients with MAD undergoing MV surgery.
Keywords:
cardiac surgerymeta-analysismitral annular disjunctionmitral valve surgeryventricular arrhythmiaMore Related Videos
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