Demolder A, Timmermans F, Duytschaever M, et al. - In the routine cardiac assessment of patients suffering from Marfan syndrome (MFS), reporting on the presence as well as extent of mitral annular disjunction (MAD) should be considered as a potential marker for adverse outcomes.

• This is a retrospective, single-center cohort study of 142 patients with MFS; 48 patients (34%) had MAD.

• A higher need for mitral valve intervention, occurrence of arrhythmic events (defined as sustained ventricular tachycardia and sudden cardiac death) was evident in relation to the presence of MAD.

• A higher occurrence of aortic events was reported in patients in the upper MAD tertile (>10 mm) vs those with MAD of 10 mm or smaller.

• Patients with MAD more often experienced ventricular arrhythmia, but not atrial arrhythmia.