ArticleEuropean heart journal2025
Mitral annular disjunction and mitral valve prolapse: long-term risk of ventricular arrhythmias after surgery.
Article in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mitral annular disjunction and high-risk profiles: a conceptual approach to risk stratification and surgical implications.General thoracic and cardiovascular surgery · 2026Pooled it
- Arrhythmogenic Mitral Valve Prolapse: Looking Beyond Mitral Regurgitation.JACC. Case reports · 2026Article
- Port-Access Robotic Repair of Barlow Mitral Annular Disjunction and Severe Mitral Valve Regurgitation.Annals of thoracic surgery short reports · 2026Article
- Cardiac arrest secondary to mitral annular disjunction: a case report.European heart journal. Case reports · 2026Article
- Case report of a rare clinical triad in mitral valve prolapse: when ventricular arrhythmias coexist with thromboembolic complications.European heart journal. Case reports · 2026Article
- The Arrhythmogenic Spectrum of Mitral Valve Disease: Pathophysiology, Risk Stratification, and Surgical Management.Journal of clinical medicine · 2026Review
- Mitral Annular Disjunction and Fibrosis in Bileaflet MVP: High-Risk Phenotype for Sudden Cardiac Arrest.JACC. Case reports · 2026Article
- Mitral Annular Disjunction: A Roadmap for the Surgeon.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026Review
- Mitral Annular Disjunction and Coalescing Myths in Cardiology.Arrhythmia & electrophysiology review · 2026Article
- Mitral Annular Disjunction: Separating the Wheat from the Chaff.Arrhythmia & electrophysiology review · 2026Article
- Mitral Valve Surgery with and Without Mitral Annular Disjunction: A Meta-Analysis.Journal of cardiovascular development and disease · 2025Review
- Mitral Annular Disjunction: Epidemiology, Diagnostic Methods, Prognosis, and Novel Implications.Journal of cardiovascular development and disease · 2025Review
- Is mitral annular disjunction the cause of arrhythmogenic mitral valve prolapse?European heart journal · 2025Article
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Authors and funding
13 authors.
Funding
Abstract
BACKGROUND AND
aimsMitral valve prolapse (MVP) is associated with progressive mitral regurgitation (MR) requiring surgical correction. A subset of patients with MVP experience ventricular arrhythmias (VA), and mitral annular disjunction (MAD) has been reported as a risk factor. This study aimed to assess the long-term risk of VA in patients with MAD and MVP undergoing mitral valve surgery for MR.
methodsPatients with MVP with moderate or severe degenerative MR undergoing mitral valve surgery (repair or replacement) in 2010-22 at Karolinska University Hospital were included. Mitral annular disjunction length, referring to true MAD, was measured at end systole on pre- and post-operative transthoracic echocardiography. The primary outcome consisted of VA including hospitalizations, outpatient visits or ablation for confirmed sustained or non-sustained ventricular tachycardia, or high burden of premature ventricular complexes and assessed from medical records.
resultsOf 599 patients undergoing mitral valve surgery, 96 (16%) had pre-operative MAD. The median MAD length was 8.0 [inter-quartile range (IQR) 5.0-10.0] mm. Compared with patients without MAD, patients with MAD were younger (55 ± 15 vs 63 ± 11 years), were more often women (31% vs 17%), and had more Barlow's disease (70% vs 27%). Mitral annular disjunction was surgically corrected in all patients. During a median follow-up time of 5.4 (IQR 2.8-7.5) years, patients with pre-operative MAD had a higher risk of VA (hazard ratio adjusted for age and sex 3.33, 95% confidence interval 1.37-8.08) regardless of repair/replacement (Pinteraction = .18).
conclusionsMitral annular disjunction in patients with MVP and MR was associated with a three-fold increased long-term risk of VA post-mitral valve surgery, despite anatomical correction of MAD.
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