Key result
Chimney Commando redo double-valve replacement demonstrates a ~10-case learning curve.
Why the study?
The reproducibility and learning curve duration of Chimney Commando technique for redo double-valve replacement were uncertain.
What is the learning curve and reproducibility of the Chimney Commando technique for redo double-valve replacement?
Observational (n=24)
No
What is the learning curve and reproducibility of the Chimney Commando technique for redo double-valve replacement?
The Chimney Commando operation for redo double-valve replacement is reproducible and has a relatively short learning curve of 10 to 12 cases to achieve significant improvements in surgical times and postoperative recovery.
Answers are grounded in this paper and cite their sources.
May guide volume thresholds at experienced centers; leaves open reproducibility and comparison to conventional Commando.
A 2025 JTCVS commentary questioned whether Chimney Commando shortens the learning curve of conventional Commando and is reproducible elsewhere 1 . We reviewed 24 consecutive redo Chimney Commando operations performed by a single surgeon at a high-volume Chinese center.Segmented regression identified a 10-case statistical breakpoint (95% CI 3.9–16.1; Spearman ρ=-0.42, P=0.043). Sensitivity analysis confirmed a 12-case clinical confirmation point where cross-clamp time (P=0.038), ventilation (P=0.034), and ICU stay (P=0.043) all improved. Zero LVOT obstruction occurred; PPM rate was 4.2%. Mortality was 12.5%. The technique is reproducible, with a 10-12 case learning curve.
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Zhu et al. (2026) conducted an observational in Redo double-valve replacement (n=24). Chimney Commando procedure was evaluated on Learning curve statistical breakpoint (10 cases (Spearman ρ -0.42), 95% CI 3.9-16.1, p=0.043). The Chimney Commando procedure for redo double-valve replacement demonstrated a 10-12 case learning curve, alongside 0% left ventricular outflow tract obstruction and 12.5% mortality.
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