Outcomes of Patients With Mitral Annular Disjunction Undergoing Mitral Valve Repair

This retrospective study compared outcomes in patients undergoing mitral valve repair for valve prolapse, with and without mitral annular disjunction (MAD). After propensity score matching, 100 patients (50 with MAD and 50 without) were analyzed. Hospital mortality was zero percent in both groups, with no significant differences in early reoperation, residual regurgitation, or major arrhythmias. However, patients with MAD showed a greater need for prolonged inotropic and mechanical circulatory support (zero percent vs 10 percent, P=0.050), indicating more frequent early left ventricular dysfunction. Despite this early difference, composite outcomes at midterm follow-up were similar between the groups, suggesting that while MAD presents initial challenges, it does not affect survival at follow-up.