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Near-Fatal Arrhythmia From Severe Mitral Annular Disjunction
Peter-Jon Williams1, Mark Schwade2, Ryan F Bloomquist3
1School of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA, augusta.edu.
Case Reports in Cardiology
|June 29, 2026
Summary
Mitral annular disjunction (MAD), a heart abnormality linked to sudden cardiac arrest, was diagnosed in a patient experiencing cardiac arrest. Advanced imaging and surgical repair proved crucial for his recovery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Mitral annular disjunction (MAD) is a structural cardiac abnormality.
- MAD is increasingly associated with ventricular arrhythmias and sudden cardiac arrest.
- Bileaflet mitral valve prolapse (MVP) is often implicated in MAD-related events.
Purpose of the Study:
- To highlight the diagnostic and risk stratification role of advanced imaging in MAD.
- To present a case of sudden cardiac arrest secondary to MAD.
- To illustrate successful surgical management of MAD.
Main Methods:
- Case report of a 43-year-old male with out-of-hospital cardiac arrest.
- Transthoracic echocardiography for diagnosis of mitral regurgitation, bileaflet prolapse, and suspected MAD.
- Implantable cardioverter-defibrillator placement for secondary prevention.
- Robotic-assisted mitral valve repair.
Main Results:
- The patient experienced a witnessed out-of-hospital cardiac arrest and was resuscitated.
- Echocardiography revealed mitral regurgitation, bileaflet prolapse, and suspected MAD.
- Successful implantation of an ICD and subsequent robotic-assisted mitral valve repair.
- Patient discharged in stable condition.
Conclusions:
- Advanced imaging is pivotal for diagnosing MAD in cardiac arrest patients.
- MAD, particularly with MVP, is a critical consideration in unexplained sudden cardiac arrest.
- Surgical intervention, including robotic-assisted repair, can be effective for MAD.
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