Commissurotomy is a surgical procedure used to treat stenosis, or narrowing, of a heart valve, most commonly the mitral valve. The procedure involves the separation of fused valve leaflets (the commissures) that are causing the valve to narrow and restrict blood flow. By carefully cutting or separating these leaflets, commissurotomy restores proper valve function, allowing blood to flow more freely through the heart. This procedure can be performed either as an open-heart surgery (open commissurotomy) or as a less invasive procedure using a balloon catheter (balloon valvuloplasty or percutaneous commissurotomy). Commissurotomy is typically required for patients with valvular stenosis, which can be caused by conditions such as rheumatic heart disease, where inflammation leads to scarring and fusion of the valve leaflets. Left untreated, valvular stenosis can result in increased pressure in the heart and lungs, leading to heart failure or other serious complications. Symptoms of valve stenosis that may lead to the need for commissurotomy include shortness of breath, fatigue, chest pain, dizziness, and swelling in the legs. These symptoms occur because the narrowed valve limits the heart's ability to pump blood effectively, leading to reduced blood flow to the body and increased pressure in the lungs and heart chambers. Commissurotomy can significantly improve symptoms and quality of life in patients with valve stenosis, restoring normal blood flow and preventing the progression of heart failure. It is an effective treatment for patients with severe stenosis, particularly those who are not candidates for valve replacement.
