Mitral Annular Disjunction in Marfan Syndrome

Mitral annular disjunction (MAD), a separation between the mitral valve hinge point and the left ventricular (LV) myocardium, is being studied as a possible marker or substrate for ventricular arrhythmia and sudden cardiac death.

This video shows the finding on parasternal long-axis view of an echocardiogram in a patient with Marfan syndrome.

In a cohort study of patients with Marfan syndrome, MAD was associated with occurrence of arrhythmic events, a higher need for mitral valve intervention, and, in patients with extensive MAD, more aortic events.