The open approach to mitral commissurotomy

2024 ACC/AHA Clinical Performance and Quality Measures for Adults With Valvular and Structural Heart Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Performance Measures

“…188,196,[203][204][205][206][207] Mitral valve surgery is an established therapy for rheumatic MS, with the preferred approach being commissurotomy (either closed, where the valve is opened blindly through the LA or LV, or open, which allows more extensive surgery under direct visualization) when anatomy is favorable. [208][209][210][211][212][213] However, in the presence of severe valvular thickening and subvalvular fibrosis with leaflet tethering, mitral valve replacement may be the best option. In addition to those who have suboptimal valve anatomy (or failed PMBC), patients with moderate or severe TR may also have a better outcome with a surgical approach that includes tricuspid valve repair.…”