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Features of diagnosis and treatment of patients with mitral annular disjunction

Authors: Ryzhova T.S., Khotsanyan Ch.V.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2025-19-1-26-34

For citation: Ryzhova T.S., Khotsanyan Ch.V. Features of diagnosis and treatment of patients with mitral annular disjunction. Creative Cardiology. 2025; 19 (1): 26–34 (in Russ.). DOI: 10.24022/1997-3187-2025-19-1-26-34

Received / Accepted:  15.01.2025 / 05.02.2025

Keywords: mitral annular disjunction echocardiography magnetic resonance imaging risk of arrhythmias sudden cardiac death catheter ablation mitral valve plastic surgery and prosthetics



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Abstract

Mitral annular disjunction (MAD) is an anomaly of the left atrioventricular junction, characterized by atrialization of the posterior leaflet of the mitral valve and separation of the myocardium of the left atrium, mitral fibrous ring and myocardium of the basal part of the left ventricle. In MAD, there is a paradoxical dynamics of the fibrous ring with its systolic expansion, flattening, and abnormal apical displacement into the systole. The interest in this anomaly is due to the association of MAD with ventricular arrhythmias, sudden cardiac death and arrhythmogenic mitral valve prolapse.

This review covers the main aspects of the diagnosis of MAD, including the features of measuring the distance of disjunction, determining its pathological threshold and stratifying the risk of arrhythmic events, as well as the main points of management tactics and surgical intervention in this category of patients.

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About Authors

  • Taisiya S. Ryzhova, Resident; ORCID
  • Chinara V. Khotsanyan, Cand. Med. Sci., Cardiologist; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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