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Related Experiment Video

Updated: Jul 6, 2025

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Modified Commando procedure using a double valve composite through an aorto-annulo-septotomy.

Kanji Matsuzaki1, Kisato Mitomi1, Akito Imai1

  • 1Department of Cardiovascular Surgery, Hitachi General Hospital, Hitachi, Japan.

Interdisciplinary Cardiovascular and Thoracic Surgery
|January 5, 2024
PubMed
Summary
This summary is machine-generated.

This study presents a modified Commando procedure for complex double valve replacement in redo surgery. The novel technique successfully addressed prosthetic valve endocarditis with improved surgical access and reconstruction.

Keywords:
Commando procedureDouble valve replacementIntervalvular fibrous bodyProsthetic valve endocarditis

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Surgical Techniques

Background:

  • Double valve replacement, particularly the Commando procedure, is complex.
  • Redo surgery for prosthetic valve endocarditis presents unique surgical challenges.
  • Specialized techniques are crucial for reconstructing the aortic and mitral valve complex.

Purpose of the Study:

  • To describe a modified Commando procedure for complex double valve replacement.
  • To evaluate the efficacy of a novel surgical approach in redo cases of prosthetic valve endocarditis.
  • To demonstrate a technique for intervalvular fibrous body reconstruction with improved visualization.

Main Methods:

  • A modified Commando procedure was performed using a double valve composite.
  • An aorto-annulo-septotomy approach was utilized for enhanced visualization.
  • Four-layer patch wings were incorporated for en bloc valve replacement and serial closure.

Main Results:

  • The modified approach provided excellent visualization of the aortic and mitral annuli.
  • The technique allowed for en bloc double valve replacement and serial closure without left atrial roof incision.
  • Successful completion of the Commando procedure for complicated prosthetic valve endocarditis was achieved.

Conclusions:

  • The modified Commando procedure offers a viable solution for complex double valve replacement in challenging redo cases.
  • The described surgical techniques facilitate safe and effective reconstruction of the valve complex in prosthetic valve endocarditis.
  • This approach enhances surgical field exposure and simplifies the reconstruction process.