Infiltrative processes that extend into the intervalvular fibrosa, such as infection or calcification, often mandate a complex reconstructive procedure known as the Commando operation. First described less than 20 years ago, this operation is not widely implemented, with experience limited to a few select centers. This report provides a detailed summary of our approach to this intricate procedure.

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http://dx.doi.org/10.1532/hsf.1514DOI Listing

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Commando procedure for radiation heart disease.

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November 2024

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The Commando procedure is an important tool to address extensive calcification of the aortic and mitral valves associated with radiation heart disease. We present a symptomatic patient with radiation heart disease associated with calcification of the mitral and aortic valves and the aortomitral curtain, which is typical of this pathology. The surgical approach consisted of exposure through aortotomy and left atrial dome, followed by aortic and mitral valve debridement, aortic and mitral valve replacement, with aortomitral curtain reconstruction using bovine pericardial patch.

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