Goldberg Rachel L, Isselbacher Eric, Murphy Sean P, Inglessis-Azueja Ignacio, Foldyna Borek, Langer Nathaniel B, Paras Molly L, Yucel Evin
Cardiovascular Disease Division, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Cardiovascular Disease Division, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
JACC Case Rep. 2025 Jun 25;30(16):104342. doi: 10.1016/j.jaccas.2025.104342.
Mitral annular disruption is increasingly recognized in our clinical practice and is most commonly due to infective endocarditis or transcatheter or hybrid balloon-expandable mitral valve deployment in the setting of mitral annular calcification.
A case series is presented of 4 patients with mitral annular disruption in 4 distinct clinical scenarios, each requiring multimodality imaging for diagnosis.
These defects are often difficult to detect on transthoracic imaging and challenging to interpret on transesophageal echocardiography given the unique flow pattern and a general unfamiliarity among echocardiographers with such a defect.
TAKE-HOME MESSAGES: These 4 cases describe mitral annular disruption caused by infective endocarditis or mitral valve replacement in the setting of mitral annular calcification. These cases stress the importance of careful multimodality cardiac imaging and maintaining a high clinical suspicion for mitral annular disruption, as it is often challenging to diagnose.
二尖瓣环破裂在我们的临床实践中越来越受到重视，最常见的原因是感染性心内膜炎，或在二尖瓣环钙化的情况下进行经导管或杂交球囊扩张二尖瓣植入术。
本文介绍了4例二尖瓣环破裂患者的病例系列，这些患者处于4种不同的临床场景，均需要多模态成像进行诊断。
这些缺损在经胸成像上通常难以检测，并且鉴于独特的血流模式以及超声心动图医生对这种缺损普遍不熟悉，在经食管超声心动图上进行解读也具有挑战性。
这4例病例描述了感染性心内膜炎或在二尖瓣环钙化情况下进行二尖瓣置换导致的二尖瓣环破裂。这些病例强调了仔细进行多模态心脏成像以及对二尖瓣环破裂保持高度临床怀疑的重要性，因为其诊断往往具有挑战性。
