Mitral annular disjunction

Mitral annular disjunction
Other namesMitral annulus disjunction
Significant mitral disjunction of the posterior annulus (top left), and of the inferior annulus (top right). Paradoxical annulus enlargement during systole (Bottom).
SpecialtyCardiology
Differential diagnosismitral valve prolapse, Anderson-Fabry disease[1]

Mitral annular disjunction (MAD) is a structural abnormality of the heart in the mitral annulus ring. It is associated with hypermobility of the mitral valve annulus, mitral valve prolapse, myxomatous degeneration of mitral valve and is generally defined as a separation between the junction of mitral valve annulus connection to atrial wall and the left ventricular attachment which allows for mitral valve to become hypermobile.[2] It can be diagnosed by echocardiography and additionally by cardiac computed tomography and cardiac MRI.[3] It is found in 42-90% of people with myxomatous degeneration of mitral valve and mitral valve prolapse and it affects women more.[3]

Risks

Mitral annular disjunction is considered a risk marker in people with mitral valve prolapse as it has an association between mitral valve prolapse and ventricular arrhythmias and myocardial fibrosis, which in some rare cases can lead to cardiac arrest.[4]

History

MAD was first described by Saroja Bharati in 1981 in a patient with mitral valve prolapse who suffered sudden cardiac death.[5][6] It was later defined by Grover M. Hutchins in 1986.[3]

References

  1. ↑ Feger, Joachim. "Mitral annulus disjunction | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Retrieved 2021-11-17.
  2. ↑ Eriksson, Maria J.; Bitkover, Catarina Y.; Omran, Ahmad S.; David, Tirone E.; Ivanov, Joan; Ali, Mohamed J.; Woo, Anna; Siu, Samuel C.; Rakowski, Harry (October 2005). "Mitral annular disjunction in advanced myxomatous mitral valve disease: echocardiographic detection and surgical correction". Journal of the American Society of Echocardiography. 18 (10): 1014–1022. doi:10.1016/j.echo.2005.06.013. ISSN 1097-6795. PMID 16198877.
  3. 1 2 3 Feger, Joachim. "Mitral annulus disjunction | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Retrieved 2021-11-05.
  4. ↑ Hernández, Keerby; Agudelo-Uribe, Juan F.; Ramírez-Barrea, Juan D.; Abad-Díaz, Pedro; Correa-Velásquez, Rafael; Sáenz-Jaramillo, Gloria (September 2021). "The mitral annulus disjunction as a risk marker in mitral valve prolapse". Archivos de cardiología de México. 91 (3): 347–354. doi:10.24875/acm.200003661. ISSN 1405-9940. PMC 8351651. PMID 33232309.
  5. ↑ Tsianaka, T.; Matziris, I.; Kobe, A.; Euler, A.; Kuzo, N.; Erhart, L.; Leschka, S.; Manka, R.; Kasel, A.M.; Tanner, F.C.; Alkadhi, H. (2021-03-09). "Mitral annular disjunction in patients with severe aortic stenosis: Extent and reproducibility of measurements with computed tomography". European Journal of Radiology Open. 8: 100335. doi:10.1016/j.ejro.2021.100335. ISSN 2352-0477. PMC 7960936. PMID 33748350.
  6. ↑ Bharati, S.; Granston, A. S.; Liebson, P. R.; Loeb, H. S.; Rosen, K. M.; Lev, M. (1981). "The conduction system in mitral valve prolapse syndrome with sudden death". American Heart Journal. 101 (5): 667–670. doi:10.1016/0002-8703(81)90235-0. ISSN 0002-8703. PMID 7223606.


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