Fig. 1.

CT assessment of mitral annular disjunction (MAD).

The MAD assessment starts on the axial plane (A). To derive the vertical long axis (VLA) view the crosshairs are adjusted to pass through the center of the mitral valve and left ventricular apex. On the VLA (B), crosshairs are adjusted to align with the left atrial wall- mitral leaflet junction (yellow markers). On the acquired short-axis view on a plane through the mitral valve (C), crosshairs are rotated to assess the corresponding long axis image (D) for the presence of MAD (orange arrow). MAD is defined as spatial displacement of the left atrial wall-mitral leaflet junction (yellow marker) and the left ventricular wall (green) during systole (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.).