Key result
Commando procedure for infective endocarditis carries ~30% early mortality and high one-year reintervention risk.
Why the study?
Destruction of the aortomitral curtain in infective endocarditis is a rare complication presenting a significant technical challenge that carries high early mortality and reintervention rates.
This article describes a surgical technique for reconstructing the aortomitral curtain in patients with infective endocarditis, a complex condition with high mortality and reintervention rates.
High early mortality and reintervention rates warrant individualized decision-making; leaves open need for prospective data to refine indications.
Infective endocarditis is associated with an early mortality up to 30% despite advanced diagnostics and antibiotic therapies, and approximately one-half of patients will require operative management.1,2 A rare complication presenting a significant technical challenge is destruction of the aortomitral curtain, a condition that often requires combined mitral and aortic valve replacement and reconstruction of the intervalvular fibrosa (Commando or hemi-Commando procedure). This procedure carries an early mortality rate of 14% to 30%, with reintervention rates up to 17% at 1 year.
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DeGraaff et al. (2025) studied Infective endocarditis with destruction of the aortomitral curtain. Giant Patch Technique for Reconstruction of the Aortomitral Curtain (Commando procedure) was evaluated. Reconstruction of the intervalvular fibrosa (Commando procedure) for infective endocarditis with aortomitral curtain destruction carries an early mortality of 14-30% and 1-year reintervention up to 17%.
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