Karangelis Dimos, Mylonas Konstantinos S, Krommydas Argyris, Loggos Spiros, Androutsopoulou Vasiliki, Stakos Dimitrios, Mikroulis Dimitrios, Tzifa Aphrodite, Mitropoulos Fotios
Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, 68100 Alexandroupoli, Greece.
Third Department of Cardiac Surgery, Onassis Cardiac Surgery Center, 10671 Athens, Greece.
Rev Cardiovasc Med. 2022 Mar 30;23(4):117. doi: 10.31083/j.rcm2304117. eCollection 2022 Apr.
Mitral annular disjunction (MAD) is a structural abnormality defined by a distinct separation of the mitral valve annulus-left atrial wall continuum and the basal aspect of the posterolateral left ventricle. This anomaly is often observed in patients with myxomatous mitral valve prolapse. Importantly, MAD has been strongly associated with serious ventricular arrhythmias and predisposes to sudden cardiac death. Therefore, we have to emphasize the need to diagnose this morphologic and functional abnormality in routine practice in order to facilitate optimal mitral valve repair and minimize patient risks. Nevertheless, clinical knowledge regarding MAD still remains limited. In the present review, we aim to shed light on several aspects of MAD, including distinct anatomical and pathophysiological characteristics, imaging modalities, association with ventricular arrhythmias, and current methods of treatment.
二尖瓣环分离（MAD）是一种结构异常，其定义为二尖瓣环-左心房壁连续体与左心室后外侧基部之间明显分离。这种异常在黏液瘤样二尖瓣脱垂患者中经常观察到。重要的是，MAD与严重室性心律失常密切相关，并易引发心脏性猝死。因此，我们必须强调在常规实践中诊断这种形态学和功能异常的必要性，以便促进最佳二尖瓣修复并将患者风险降至最低。然而，关于MAD的临床知识仍然有限。在本综述中，我们旨在阐明MAD的几个方面，包括独特的解剖学和病理生理学特征、成像方式、与室性心律失常的关联以及当前的治疗方法。
