Mitral Commissurotomy

Excerpt

Mitral valve commissurotomy is a surgical procedure designed to relieve mitral stenosis by separating the fused commissures of the mitral valve. This condition, commonly a result of rheumatic heart disease, leads to a narrowing of the mitral valve orifice, impeding blood flow from the left atrium to the left ventricle and resulting in elevated atrial pressures and pulmonary hypertension. Since its initial development in the early 20th century, mitral commissurotomy has evolved from open surgical techniques to percutaneous balloon approaches, offering less invasive options for certain patient populations.

Mitral valve commissurotomy, a procedure indicated primarily for patients with symptomatic mitral stenosis who are unsuitable for valve replacement, remains a key intervention in low-resource settings where rheumatic heart disease is prevalent. The procedure can be performed either through an open surgical approach or percutaneously, with each modality offering distinct advantages depending on valve morphology and patient characteristics.