Mitral annular disjunction: A systematic review of the literature

Echocardiography
Sadie BennettChun Shing Kwok

Abstract

Mitral annular disjunction (MAD) is a structural abnormality where there is a separation between the mitral valve annulus and the left atrial wall which is not well understood. We conducted a systematic review to evaluate the prevalence of MAD, factors associated with MAD and clinical outcomes among patients with MAD. A total of 19 studies were included in this review, and the number of noncase report studies had between 23 and 1439 patients. The pooled rate of MAD in studies of myxomatous mitral valve patients was 66/130 (50.8%, 3 studies), and among patients with mitral valve prolapse was 95/291 (32.6%, 3 studies). One study suggests that 78% of patients with MAD had mitral valve prolapse, and another suggested it was strongly associated with myxomatous mitral valve disease (HR 5.04 95% CI 1.66-15.31). In terms of clinical significance, it has been reported that MAD with disjunction > 8.5 mm was associated with nonsustained ventricular tachycardia (OR 10 95% CI 1.28-78.1). There is also evidence that gadolinium enhancement in papillary muscle (OR 4.09 95% CI 1.28-13.05) and longitudinal MAD distance in posterolateral wall (OR 1.16 95% CI 1.02-1.33) was predictive of ventricular arrhythmia and late gadolinium enhancement in an...Continue Reading

References

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Citations

Jul 1, 2020·Nature Reviews. Cardiology·Benedetto Del FornoOttavio Alfieri
Dec 4, 2020·Echocardiography·Kushani GajjarRobert W W Biederman
Dec 8, 2020·Echocardiography·Ritu ThammanRajeev Gupta
Mar 5, 2021·Frontiers in Cardiovascular Medicine·Bhupendar TayalDipan J Shah
Apr 12, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Andreas HagendorffSebastian Ewen
Jun 12, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Thushara MadathilPatrick Perier
Jul 29, 2021·JACC. Case Reports·Ritu Thamman
Aug 3, 2021·Frontiers in Pediatrics·Laura Muiño-Mosquera, Julie De Backer
Oct 16, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Noriaki KishimotoToshihiko Shibata

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