Modified Commando operation using stentless aortic bioprosthesis

Operations necessitating intervalvular fibrous body reconstruction in patients with extensive endocarditis are referred to as "Commando operations," an indicator of the procedure's difficulty. Aortic root replacement is inevitable when performing the Commando operation for extensive aortic annular defect after radical debridement. We performed a modified Commando operation, in which supra-annular aortic valve replacement with the Solo Smart stentless bioprosthesis was employed instead of aortic root replacement. Supra-annular implantation can spare damaged annular structures. This modification is expected to render complex reconstructive surgery technically less demanding.