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Commissurotomy is an open-heart surgery that repairs a mitral valve that is narrowed from mitral valve stenosis.
During this surgery, a person is put on a heart-lung bypass machine. The surgeon removes calcium deposits and other scar
tissue from the valve leaflets. The surgeon may cut parts of the valve structure. This surgery opens the valve.
used for people who have severe narrowing of the valve and aren't good
candidates for balloon valvotomy.
Symptoms of mitral valve stenosis improve after commissurotomy.
You will feel tired and sore for the first few weeks after surgery. You may have some brief, sharp pains on either side of your chest. Your chest, shoulders, and upper back may ache. The incision in your chest may be sore or swollen. These symptoms usually get better after 4 to 6 weeks.
You will probably be able to do many of your usual activities after 4 to 6 weeks. But for at least 6 weeks, you will not be able to lift heavy objects or do activities that strain your chest or upper arm muscles. At first you may notice that you get tired easily and need to rest often. It may take 1 to 2 months to get your energy back.
Even though the surgery repaired your mitral valve, it is still important to eat a heart-healthy diet, get regular exercise, not smoke, take your heart medicines, and reduce stress. Your doctor may recommend that you work with a nurse, a dietitian, and a physical therapist to make these changes. This is sometimes called cardiac rehabilitation.
For more information, see Heart Valve Surgery: Recovery.
If symptoms happen again after
surgery, tell your doctor. You will be asked about your symptoms
and will probably have tests to check your heart valves.
Sometimes these symptoms are due to the mitral valve narrowing again
Commissurotomy is used for people who have severe
narrowing of the valve and aren't good candidates for balloon valvotomy. A commissurotomy is most often done if the mitral valve is very damaged or has a lot of calcium buildup.
After surgery, symptoms are relieved because the surgery opens the narrowed mitral valve, allowing blood to flow more easily through the heart.
A commissurotomy surgery has the risks of any open-heart surgery with a heart-lung bypass. The exact risks of surgery vary
depending on the person's specific condition and general health prior to
Risks during surgery and soon after surgery. These risks include dangerous blood clots, bleeding, infection, stroke, and risks associated with anesthesia. About 1 out of 100 people die from this surgery.footnote 1
Risks after surgery. Complications that happen after surgery include:
Deciding whether you need
treatment for mitral valve stenosis—and if so, when—is a major decision. To make this decision, you and your doctor will consider the
severity of your mitral valve stenosis and the risks of surgery.
Although most people have successful outcomes from commissurotomy surgery, the risk of death and serious
problems during surgery is real. It should be strongly weighed in the decision
to replace your valve, particularly if you have other serious health
For more information about valve repair and valve replacement options, see Mitral Valve Stenosis: Repair or Replace the Valve?
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Otto CM, Bonow RO (2012). Valvular heart disease. In RO Bonow et al., eds., Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 2, pp. 1468–1539. Philadelphia: Saunders.
Other Works Consulted
Nishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.
ByHealthwise StaffPrimary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, ElectrophysiologySpecialist Medical ReviewerJohn A. McPherson, MD, FACC, FSCAI - Cardiology
Current as ofApril 3, 2017
Current as of:
April 3, 2017
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
& John A. McPherson, MD, FACC, FSCAI - Cardiology
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