Double valve replacement of aortic and mitral valves with intervalvular fibrous body reconstruction (Commando procedure) is a challenging operation. Particularly in redo surgery for prosthetic valve endocarditis, special techniques are needed for approaching and reconstructing the valve complex. We performed a modified Commando procedure using a double valve composite through an aorto-annulo-septotomy. This approach provided a good field of vision at the combined aortic and mitral annulus without incising the left atrial roof. The double valve composite with four-layer patch wings was useful for performing double valve replacement en-bloc and aorto-annulo-septotomy closure serially. Using these techniques, we successfully performed the Commando procedure for complicated prosthetic valve endocarditis.
Keyphrases
- aortic valve
- mitral valve
- aortic stenosis
- left atrial
- aortic valve replacement
- transcatheter aortic valve replacement
- transcatheter aortic valve implantation
- left ventricular
- minimally invasive
- ejection fraction
- atrial fibrillation
- coronary artery
- acute coronary syndrome
- pulmonary hypertension
- pulmonary arterial hypertension