Abstract 13449: Mitral Annular Disjunction in Patients With Severe Mitral Regurgitation
Background: Mitral annular disjunction (MAD) is pathologically defined by a separation between atrial wall-mitral valve (MV) junction and the left ventricular attachment.
Methods: We studied 185 consecutive patients with severe mitral regurgitation causing floppy mitral valve referred to our echocardiography laboratory from March in 2009 to Deember in 2010. The upper limit of the disjunction was defined at the level of posterior scallop insertion into the left atrial (LA) wall, whereas the lower limit of the disjunction was defined at the level of LA connection with ventricular myocardium. The distance between two levels was measured as MAD. The severity of mitral regurgitation (MR) was semiquantitatively evaluated. The prolapsing sites were divided in anterior leaflet, posterior leaflet, commissural site and Barlow’ type. We divided the patients with MAD. Type 0 was defined no distance of MV disjunction and no hypermobility of the mitral annulus. Type Iwas defined as no distance of MV junction, but the hypermobility of the mitral annulus. Type II was defined as <5 mm of the diameter of MAD and Type IIIwas as ≧ 5 mm.
Results: As shown in Figure. We detected 14 patients (7.6%) with Type 0, 123 patients with TypeI(66.5%), 47 patients (25.4%) with Type IIand only one patient with Type III. The majority site of prolapse was posterior leaflet (115 patients; 62.2%).
Conclusions: MAD was detected in patients with severe MR and there were significant differences of prolapse sites.
- © 2013 by American Heart Association, Inc.