CTICasesPectus Excavatum with Bi-atrioventricular Valve Prolapse and Mitral Annular Disjunction
Imaging findings
Chest CT and cardiac MR show severe pectus excavatum with the sternum nearly touching the spine, causing marked leftward displacement of the heart. Cardiac MR demonstrates bi-atrioventricular valve prolapse with elongated, dysplastic, and scalloped mitral and tricuspid valve leaflets showing severe billowing. There is also a pronounced mitral annular disjunction measuring over one centimeter, where the posterior mitral leaflet pouches backwards away from the left ventricular myocardium.
Key takeaways
Severe pectus excavatum is frequently associated with connective tissue disorders and valvular abnormalities. Mitral annular disjunction is a key component of severe mitral valve prolapse that is associated with ventricular arrhythmias and should be carefully evaluated on three-chamber cardiac MR or CT views for pre-operative planning.
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