Key result
Commando procedure enables intervalvular fibrous body reconstruction in extensive double-valve infective endocarditis.
Why the study?
Surgical reconstruction of the intervalvular fibrous body carries high mortality and is often avoided due to lack of experience, despite being needed in extensive infective endocarditis.
The article describes the surgical technique and institutional experience for the Commando procedure in complex double-valve infective endocarditis.
Surgeons should approach IVFB reconstruction cautiously given high mortality in complex IE; level 5 evidence leaves open optimal resection protocols.
In rare cases of extensive aortic root or mitral valve infective endocarditis (IE), severe calcification of the aortic and mitral valves, or double-valve procedures in patients with small aortic and mitral annuli, surgical reconstruction of the intervalvular fibrous body (IVFB) is required. A high mortality is generally associated with this procedure, and it is frequently avoided by surgeons due to a lack of experience. It is crucial to radically resect all tissues that are severely affected by IE to prevent recurrence in the patient. Our experience with the Commando procedure in patients with extensive double-valve IE involving the IVFB is presented in this article.
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Zubarevich et al. (2020) studied Extensive double-valve infective endocarditis (IE) involving the intervalvular fibrous body (IVFB). Commando procedure (surgical reconstruction of the intervalvular fibrous body) was evaluated. The Commando procedure for surgical reconstruction of the intervalvular fibrous body is presented based on the authors' experience in patients with extensive double-valve infective endocarditis.
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