A. To review mitral valve disjunction (MVD)B. Role of MRI in the evaluation of radiological features associated with and pitfalls.

1. BACKGROUND1.1. DefinitionMitral valve disjunction (MVD) is the atrial displacement (>1 mm) of the mitral valve leaflets hinge point to the atrioventricular (AV) junction. [Fig 1]It is measured from the top edge of the ventricular wall to the hinge of the leaflet from the left atrial wall, at end-systolic phase (in which the ventricular lumen is smallest). [Fig 2]1.2. PathologyAlteration of the anatomical relationship between the wall of the left atrium, the mitral annulus and the myocardium of the left ventricle (LV). [Fig 3]The normal...

2. REPRESENTATIVE CASES2.1. Type II and III[Fig 12] [Fig 13] [Fig 14] [Fig 15]2.2. Radiological associations Mitral valve elongation [Fig 16] Mitral valve thickening Mitral thickening is usually secondary to concomitant myxomatous degeneration. [Fig 17] Subvalvular apparatus abnormalities Alterations in the subvalvular apparatus could condition the outcome of surgical repair, although their influence remains uncertain. [Fig 18] Mitral valve prolapse (MVP) Mitral prolapse is defined as a superior displacement of the mitral valve of at least 2 mm during systole. MVP is a functional characteristic...

3. CONCLUSIONS Mitral valve dysjunction is a frequent and underestimated entity. It consists of atrial displacement of the insertion of the mitral leaflet and involves biomechanical and structural alterations. Mainly loss of mechanical coupling to the LV, papillary muscle fibrosis and myxomatous degeneration of the leaflets. It is classified according to the distance/separation of the leaflet from the ventricular myocardium (in three types) and according to the location in the mitral annulus; the most frequent location is posterolateral disjunction due to intrinsic weakness. It is...

A. Gil Boronat: Nothing to disclose M. D. L. Á. Méndez: Nothing to disclose P. Torres Rubio: Nothing to disclose J. Alarcón Rodríguez: Nothing to disclose J. J. Martín Pinacho: Nothing to disclose Á. Arribas Marcos: Nothing to disclose M. Á. Gómez Bermejo: Nothing to disclose

4. REFERENCES Souza, Alexandre Costa, et al. "Disjunção do Anel Mitral: Modalidades Diagnósticas, Implicações Clínicas e Evolução Prognóstica.”Wu, Stephanie, and Robert J. Siegel. "Mitral annular disjunction: A case series and review of the literature." Frontiers in Cardiovascular Medicine 9 (2022): 976066.Hernández, Keerby, et al. "The mitral annulus disjunction as a risk marker in mitral valve prolapse." Arch Cardiol Mex (Eng)91.3 (2021): 313-320Perazzolo Marra, Martina, et al. "Morphofunctional abnormalities of mitral annulus and arrhythmic mitral valve prolapse." Circulation: Cardiovascular Imaging 9.8 (2016): e005030.Zugwitz, Dasa, et al....